Yusuke Watanabe1, Katherine M McKendy2, Elif Bilgic2, Ghada Enani2, Amin Madani2, Amani Munshi2, Liane S Feldman2, Gerald M Fried2, Melina C Vassiliou2. 1. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Avenue, D6-136, Montreal, QC, H3G 1A4, Canada. ywatanabe328@gmail.com. 2. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Avenue, D6-136, Montreal, QC, H3G 1A4, Canada.
Abstract
BACKGROUND: Current simulations for laparoscopic suturing do not reflect the complexity of the skills required in the operating room. The purpose of this study was to develop three novel advanced suturing tasks with assessment metrics and to collect validity evidence for their measures of suturing skill. METHODS: We developed three tasks based on training gaps identified through a previous needs assessment: needle handling (NH), suturing under tension (UT), and continuous suturing (CS). Minimally invasive surgeons (MIS) and senior surgical residents (SR) completed these tasks and a questionnaire regarding their educational value. Performance was assessed by two raters based on time and accuracy. Validity was assessed by comparing performance according to the level of training and self-reported experience. The inter-rater reliability and internal consistency of the tasks were calculated. RESULTS: Thirty-one subjects (13 MIS, 18 SR) were enrolled in the study (median age 32; 77% male). Compared to the SR group, the MIS group had significantly greater scores on all tasks. While all MIS surgeons completed the three tasks within the allotted time, six (33%) residents could not complete at least one out of the three tasks. Laparoscopic suturing experience correlated positively with the scores of all tasks (NH 0.51, UT 0.70, CS 0.65. p < 0.01). Inter-rater reliability for all tasks was 0.99, and internal consistency was 0.80. The majority of participants agreed that the tasks were relevant to practice, helped improve technical competence, and adequately measured suturing ability. CONCLUSIONS: This study provides validity evidence for three novel advanced laparoscopic suturing tasks. Performance on all tasks correlated significantly with training level and self-reported experience. Integrating these tasks into educational curricula may help improve residents' suturing skills and better prepare residents for the operating room.
BACKGROUND: Current simulations for laparoscopic suturing do not reflect the complexity of the skills required in the operating room. The purpose of this study was to develop three novel advanced suturing tasks with assessment metrics and to collect validity evidence for their measures of suturing skill. METHODS: We developed three tasks based on training gaps identified through a previous needs assessment: needle handling (NH), suturing under tension (UT), and continuous suturing (CS). Minimally invasive surgeons (MIS) and senior surgical residents (SR) completed these tasks and a questionnaire regarding their educational value. Performance was assessed by two raters based on time and accuracy. Validity was assessed by comparing performance according to the level of training and self-reported experience. The inter-rater reliability and internal consistency of the tasks were calculated. RESULTS: Thirty-one subjects (13 MIS, 18 SR) were enrolled in the study (median age 32; 77% male). Compared to the SR group, the MIS group had significantly greater scores on all tasks. While all MIS surgeons completed the three tasks within the allotted time, six (33%) residents could not complete at least one out of the three tasks. Laparoscopic suturing experience correlated positively with the scores of all tasks (NH 0.51, UT 0.70, CS 0.65. p < 0.01). Inter-rater reliability for all tasks was 0.99, and internal consistency was 0.80. The majority of participants agreed that the tasks were relevant to practice, helped improve technical competence, and adequately measured suturing ability. CONCLUSIONS: This study provides validity evidence for three novel advanced laparoscopic suturing tasks. Performance on all tasks correlated significantly with training level and self-reported experience. Integrating these tasks into educational curricula may help improve residents' suturing skills and better prepare residents for the operating room.
Authors: Gerald M Fried; Liane S Feldman; Melina C Vassiliou; Shannon A Fraser; Donna Stanbridge; Gabriela Ghitulescu; Christopher G Andrew Journal: Ann Surg Date: 2004-09 Impact factor: 12.969
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Authors: Yusuke Watanabe; E Matt Ritter; Steven D Schwaitzberg; James R Korndorffer; Daniel J Scott; Allan Okrainec; Elif Bilgic; Pepa A Kaneva; Mary T O'Donnell; Liane S Feldman; Gerald M Fried; Melina C Vassiliou Journal: Surg Endosc Date: 2014-07-18 Impact factor: 4.584
Authors: Felix Nickel; Jonathan D Hendrie; Karl-Friedrich Kowalewski; Thomas Bruckner; Carly R Garrow; Maisha Mantel; Hannes G Kenngott; Philipp Romero; Lars Fischer; Beat P Müller-Stich Journal: Langenbecks Arch Surg Date: 2016-04-07 Impact factor: 3.445
Authors: Jonathan D Hendrie; Felix Nickel; Thomas Bruckner; Karl-Friedrich Kowalewski; Carly R Garrow; Maisha Mantel; Philipp Romero; Beat P Müller-Stich Journal: Trials Date: 2016-01-07 Impact factor: 2.279