Literature DB >> 19123023

Laparoscopic surgical skills assessment: can simulators replace experts?

Michael Pellen1, Liam Horgan, J Roger Barton, Stephen Attwood.   

Abstract

INTRODUCTION: Global Rating Scales (GRS) quantify and structure subjective expert assessment of skill. Hybrid simulators measure performance during physical laparoscopic tasks through instrument motion analysis. We assessed whether motion analysis metrics were as accurate as structured expert opinion by using GRS.
METHODS: A random sample of 10 consultant laparoscopic surgeons, 10 senior trainees, and 10 novice students were assessed on a Sharp Dissection task. Coded video footage was reviewed by two blinded assessors and scored using a Likert Scale. Correlation with metrics was tested using Spearman's rho. Inter-rater reliability was measured using intraclass correlation coefficient (ICC).
RESULTS: Strongest GRS-Metric correlations were found for Time/Motion/Progress with Time (Spearman's rho 0.88; p < 0.05) and Instrument Handling with Path Length (Spearman's rho 0.8; p < 0.05). Smoothness correlated with Respect for Tissue in Rater 1 (rho 0.68) but not Rater 2 (rho 0.18). Mean GRS showed stronger inter-rater agreement than individual scale components (ICC 0.68). Correlation coefficients with actual experience group were 0.58-0.74 for mean GRS score and 0.67-0.78 for metrics (Spearman's rho, p < 0.05).
CONCLUSIONS: Metrics correlate well with GRS assessment, supporting concurrent validity. Metrics predict experience level as accurately as global rating and are construct valid. Hybrid simulators could provide resource-efficient feedback, freeing trainers to concentrate on teaching.

Mesh:

Year:  2009        PMID: 19123023     DOI: 10.1007/s00268-008-9866-4

Source DB:  PubMed          Journal:  World J Surg        ISSN: 0364-2313            Impact factor:   3.352


  35 in total

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2.  Transfer of training in acquiring laparoscopic skills.

Authors:  P L Figert; A E Park; D B Witzke; R W Schwartz
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Review 3.  Metrics for objective Assessment.

Authors:  R M Satava; A Cuschieri; J Hamdorf
Journal:  Surg Endosc       Date:  2002-11-20       Impact factor: 4.584

4.  Surgical competence and surgical proficiency: definitions, taxonomy, and metrics.

Authors:  Richard M Satava; Anthony G Gallagher; Carlos A Pellegrini
Journal:  J Am Coll Surg       Date:  2003-06       Impact factor: 6.113

5.  Toward reliable operative assessment: the reliability and feasibility of videotaped assessment of laparoscopic technical skills.

Authors:  D Dath; G Regehr; D Birch; C Schlachta; E Poulin; J Mamazza; R Reznick; H M MacRae
Journal:  Surg Endosc       Date:  2004-10-26       Impact factor: 4.584

6.  The reliability of multiple objective measures of surgery and the role of human performance.

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7.  The MISTELS program to measure technical skill in laparoscopic surgery : evidence for reliability.

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Journal:  Surg Endosc       Date:  2006-02-27       Impact factor: 4.584

8.  A competency-based virtual reality training curriculum for the acquisition of laparoscopic psychomotor skill.

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9.  The effect of practice on performance in a laparoscopic simulator.

Authors:  A M Derossis; J Bothwell; H H Sigman; G M Fried
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10.  Psychomotor skills assessment in practicing surgeons experienced in performing advanced laparoscopic procedures.

Authors:  Anthony G Gallagher; C Daniel Smith; Steven P Bowers; Neal E Seymour; Adam Pearson; Steven McNatt; David Hananel; Richard M Satava
Journal:  J Am Coll Surg       Date:  2003-09       Impact factor: 6.113

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2.  Randomized controlled trial on the effect of coaching in simulated laparoscopic training.

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3.  Going Beyond the Checklist with Hybrid Simulation.

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Review 4.  Is motion analysis a valid tool for assessing laparoscopic skill?

Authors:  John D Mason; James Ansell; Neil Warren; Jared Torkington
Journal:  Surg Endosc       Date:  2012-12-12       Impact factor: 4.584

5.  Preoperative warm-up using a virtual reality simulator.

Authors:  Radu Moldovanu; Eugen Târcoveanu; Gabriel Dimofte; Cristian Lupaşcu; Costel Bradea
Journal:  JSLS       Date:  2011 Oct-Dec       Impact factor: 2.172

6.  Development of a Sustainable Simulator and Simulation Program for Laparoscopic Skills Training in Haiti.

Authors:  Emile Damas; Chesnel Norcéide; Yvel Zephyr; Kerry-Lynn Williams; Tia Renouf; Adam Dubrowski
Journal:  Cureus       Date:  2016-06-05

7.  Assessment of training and selected factors on speed and quality of performing different tasks on the endoscopic simulator.

Authors:  Maciej Kasprzyk; Michał Łuczak; Nel Kaczmarek; Jakub Psiuk; Marta Twardowska; Piotr Czarnecki
Journal:  Wideochir Inne Tech Maloinwazyjne       Date:  2020-07-16       Impact factor: 1.195

  7 in total

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