Timothy M Kowalewski1, Robert Sweet2, Thomas S Lendvay3, Ashleigh Menhadji4, Timothy Averch5, Geoffrey Box6, Timothy Brand7, Michael Ferrandino8, Jihad Kaouk9, Bodo Knudsen6, Jaime Landman10, Benjamin Lee11, Bradley F Schwartz12, Elspeth McDougall13. 1. Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota. 2. Department of Urology, University of Minnesota, Minneapolis, Minnesota. Electronic address: rsweet@umn.edu. 3. Department of Urology, University of Washington and Seattle Children's Hospital, Seattle, Washington. 4. Boston University School of Medicine, Boston, Massachusetts. 5. University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania. 6. Department of Urology, Ohio State University, Cleveland, Ohio. 7. Madigan Army Medical Center, Uniformed Services University of the Health Sciences, Tacoma, Washington. 8. Department of Urology, Duke University, Durham, North Carolina. 9. Columbus and Cleveland Clinic, Cleveland, Ohio. 10. Department of Urology, University of California-Irvine, Orange, California. 11. Department of Urology and Oncology, Tulane University, New Orleans, Louisiana. 12. Division of Urology, Southern Illinois University, Carbondale, Illinois. 13. Department of Urologic Sciences, University of British Colombia, Vancouver, British Columbia, Canada.
Abstract
PURPOSE: Standardized assessment of laparoscopic skill in urology is lacking. We investigated whether the AUA (American Urological Association) BLUS (Basic Laparoscopic Urologic Skills) skill tasks are valid to address this need. MATERIALS AND METHODS: This institutional review board approved study included 27 medical students, 42 urology residents, 18 fellows and 37 faculty urologists across 8 sites. Using the EDGE (Electronic Data Generation and Evaluation) device (Simulab, Seattle, Washington) 454 recordings were collected on peg transfer, pattern cutting, suturing and clip applying tasks, which together comprise the expert determined BLUS tasks. We collected synchronized video and tool motion data for each trial. For each task errors, time, path length, economy of motion, peak grasp force and EDGE score were collected. An expert panel of 5 faculty members performed GOALS (Global Objective Assessment of Laparoscopic Skills) evaluations on a representative subset of peg transfer and suturing skill tasks performed by 24 participants (IRR = 0.95). RESULTS: Demographically derived skill levels proved unsuitable to evaluate construct validity. Separation of mean scores by grouped skill levels was strongest for the suturing task. Objective motion metrics and errors supported construct validity vis-à-vis correlation with blinded expert video ratings (motion metrics R(2) = 0.95, p <0.01). Expert scores appeared to reward errors in suturing but not in block transfer. CONCLUSIONS: BLUS skill task performance scoring can discriminate among basic laparoscopic technical skill levels. Self-reported demographics are an unreliable source of determining laparoscopic technical skill.
PURPOSE: Standardized assessment of laparoscopic skill in urology is lacking. We investigated whether the AUA (American Urological Association) BLUS (Basic Laparoscopic Urologic Skills) skill tasks are valid to address this need. MATERIALS AND METHODS: This institutional review board approved study included 27 medical students, 42 urology residents, 18 fellows and 37 faculty urologists across 8 sites. Using the EDGE (Electronic Data Generation and Evaluation) device (Simulab, Seattle, Washington) 454 recordings were collected on peg transfer, pattern cutting, suturing and clip applying tasks, which together comprise the expert determined BLUS tasks. We collected synchronized video and tool motion data for each trial. For each task errors, time, path length, economy of motion, peak grasp force and EDGE score were collected. An expert panel of 5 faculty members performed GOALS (Global Objective Assessment of Laparoscopic Skills) evaluations on a representative subset of peg transfer and suturing skill tasks performed by 24 participants (IRR = 0.95). RESULTS: Demographically derived skill levels proved unsuitable to evaluate construct validity. Separation of mean scores by grouped skill levels was strongest for the suturing task. Objective motion metrics and errors supported construct validity vis-à-vis correlation with blinded expert video ratings (motion metrics R(2) = 0.95, p <0.01). Expert scores appeared to reward errors in suturing but not in block transfer. CONCLUSIONS: BLUS skill task performance scoring can discriminate among basic laparoscopic technical skill levels. Self-reported demographics are an unreliable source of determining laparoscopic technical skill.
Authors: Rodney L Dockter; Thomas S Lendvay; Robert M Sweet; Timothy M Kowalewski Journal: Int J Comput Assist Radiol Surg Date: 2017-05-18 Impact factor: 2.924
Authors: Jason D Kelly; Ashley Petersen; Thomas S Lendvay; Timothy M Kowalewski Journal: Int J Comput Assist Radiol Surg Date: 2020-09-30 Impact factor: 2.924
Authors: Domenico Veneziano; Achilles Ploumidis; Silvia Proietti; Theodoros Tokas; Guido Kamphuis; Giovanni Tripepi; Ben Van Cleynenbreugel; Ali Gozen; Alberto Breda; Joan Palou; Kemal Sarica; Evangelos Liatsikos; Kamran Ahmed; Bhaskar K Somani Journal: World J Urol Date: 2019-03-27 Impact factor: 4.226
Authors: Jason D Kelly; Ashley Petersen; Thomas S Lendvay; Timothy M Kowalewski Journal: Int J Comput Assist Radiol Surg Date: 2020-04-15 Impact factor: 2.924
Authors: Geb W Thomas; Steven Long; Marcus Tatum; Timothy Kowalewski; Dominik Mattioli; J Lawrence Marsh; Heather R Kowalski; Matthew D Karam; Joan E Bechtold; Donald D Anderson Journal: Iowa Orthop J Date: 2020