A global assessment tool for evaluation of intraoperative laparoscopic skills

Background: Practice on Virtual Reality simulators (VRS) have been shown to improve surgical performance. However, VRS are expensive and usually housed in surgical skills centres that may be inaccessible at times convenient for surgical trainees to practice. Conversely, box trainers are inexpensive and can be used anywhere at anytime. This study assesses "take-home" Box Trainers (BT) as an alternative to VRS.Methods: After baseline assessments (two simulated laparoscopic cholecystectomies, one on a VRS and one on a BT) 25 surgical trainees were randomised to two groups. Trainees were asked to practice 3 basic laparoscopic tasks for 6 weeks (BT group using a "take-home" box trainer; VR group using VRS in clinical skills centres). After the practice period all performed two LC, one on a VRS and one on a BT; (i.e. post-training assessment). VRS provided metrics (total time (TT), number of movements (NOM) instrument tip path length (PL)) and expert video assessment of cholecystectomy in a BT (GOALS score) were recorded. Performance during pre-and post-training assessment was compared.Results: The BT group showed a significant improvement for all VRS metrics (p=0.008) and the efficiency category of GOALS score (p=0.03). Only TT improved in the VRS group and none of the GOALS categories demonstrated a statistically significant improvement after training.

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“…A validated scoring scheme, Global Operative Assessment of Laparoscopic Skills (GOALS) [17], was used for this purpose. The "autonomy" …”

Section: Evaluation Of Cholecystectomy Performed On Vr Simulatormentioning

confidence: 99%

“Take-home” box trainers are an effective alternative to virtual reality simulators

Yiasemidou

Siqueira

Tomlinson

et al. 2017

Journal of Surgical Research

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“…Assessment based on In-Training Evaluation Reports (ITERs) [9] is subjective, expensive, and prone to undesirable side effects, such as a halo effect [10]. The halo effect is a result of influenced perception of the performance in one área (e.g., laparoscopic task) by the performance in another área (e.g., relationship between trainee and mentor) [11]. Additionally the ITERs are periodically written, depriving the trainee of immediate feedback, and are subject to the evaluators' long-term memory [12].…”

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confidence: 99%

“…Structured reports, based on checklists and immediate end-product analysis have been proposed and validated [11,[13][14][15][16]. The Objective Structured Clinical Examination (OSCE) [13] has been used to assess clinical performance of trainees on various clinical stations (comprising different tasks).…”

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confidence: 99%

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Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

133

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Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentortrainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons' psychomotor skills. Ongoing development of tracking systems and software Solutions has allowed for the expansión of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentáis of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as 1 To whom correspondence and reprint requests should be addressed at Bioengineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Universidad Politécnica de Madrid (UPM). Avda Complutense, 30, 28040, Madrid, Spain. E-mail: ioropesa@gbt.tfo. upm.es. well as optimize their already overloaded training schedules.

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“…Especially during training, objective assessment and structured feedback is essential to correct deficiencies [32]. Other scoring forms have been described [33]. We choose OSATS because it is a standardized form with which a lot of experience has been gained.…”

Section: Discussionmentioning

confidence: 99%

Implementing an Advanced Laparoscopic Procedure by Monitoring with a Visiting Surgeon

Briët

Mourits

Kenkhuis

et al. 2010

Journal of Minimally Invasive Gynecology

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A global assessment tool for evaluation of intraoperative laparoscopic skills

Cited by 766 publications

References 25 publications

“Take-home” box trainers are an effective alternative to virtual reality simulators

“Take-home” box trainers are an effective alternative to virtual reality simulators

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Implementing an Advanced Laparoscopic Procedure by Monitoring with a Visiting Surgeon

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