Development of assessing generic and specific technical skills in laparoscopic surgery

Sarker, Sudip K.; Chang, Avril; Vincent, Charles; Darzi, Sir Ara

doi:10.1016/j.amjsurg.2005.07.031

Cited by 51 publications

(41 citation statements)

References 12 publications

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“…The basic CTA methodology consists of videotaping and analysing the laparoscopic view and a view of the surgeon, observational analysis, concurrent verbal protocols and postoperation interviews. This resulted in the development of an initial protocol for CTA of laparoscopic cholecystectomy as previously published [8].…”

Section: Developmentmentioning

confidence: 99%

“…For these two last modules the correct answers were based on two experienced surgeons assessing each video independently and concluding the best option as the correct answer. Interrater reliability for each correct answer had to be j = 1.00 for the video clip question to be included in the learning tool as previously published [8].…”

Section: Stage 2: Implementationmentioning

confidence: 99%

“…LapSkill has been developed as one such tool by the first two authors. It is based on laparoscopic cholecystectomy, an elective operation performed routinely in large numbers in the UK and worldwide [8], and consists of three modules, assessing the didactic knowledge of the operation, surgical technique and task-related decisionmaking ability of the operator during the procedure. These three key elements have been chosen because they are required in combination for a surgeon to be able to operate independently and competently.…”

Section: Introductionmentioning

confidence: 99%

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A decision-making learning and assessment tool in laparoscopic cholecystectomy

et al. 2008

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Our computer-based decision-making learning tool for laparoscopic cholecystectomy seems to have face, content, concurrent and construct validities. Surgical decision making is a multifaceted process; by assessing how and why decisions are made effectively, focussed surgical training may be achieved. We aim in the future to determine if the self-appraisal decision-making tool improves or accelerates surgical training.

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Section: Developmentmentioning

confidence: 99%

Section: Stage 2: Implementationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A decision-making learning and assessment tool in laparoscopic cholecystectomy

et al. 2008

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“…Each GRS item was scored from 1 (worst) to 5 (best), whereas each STS item was scored in increments of two points from 2 (worst) to 10 (best) [6,7,8]. For the purpose of the present study, the OSATS items used by Sarker et al [7] were slightly modified. The GRS assessment was supplemented by a further criterion concerning the quantity and quality of required assistance.…”

Section: Methodsmentioning

confidence: 99%

Direct Observation versus Endoscopic Video Recording-Based Rating with the Objective Structured Assessment of Technical Skills for Training of Laparoscopic Cholecystectomy

Nickel

Hendrie²,

Stock³

et al. 2016

Eur Surg Res

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Purpose: The validated Objective Structured Assessment of Technical Skills (OSATS) score is used for evaluating laparoscopic surgical performance. It consists of two subscores, a Global Rating Scale (GRS) and a Specific Technical Skills (STS) scale. The OSATS has accepted construct validity for direct observation ratings by experts to discriminate between trainees' levels of experience. Expert time is scarce. Endoscopic video recordings would facilitate assessment with the OSATS. We aimed to compare video OSATS with direct OSATS. Methods: We included 79 participants with different levels of experience [58 medical students, 15 junior residents (novices), and 6 experts]. Performance of a cadaveric porcine laparoscopic cholecystectomy (LC) was evaluated with OSATS by blinded expert raters by direct observation and then as an endoscopic video recording. Operative time was recorded. Results: Direct OSATS rating and video OSATS rating correlated significantly (ρ = 0.33, p = 0.005). Significant construct validity was found for direct OSATS in distinguishing between students or novices and experts. Students and novices were not different in direct OSATS or video OSATS. Mean operative times varied for students (73.4 ± 9.0 min), novices (65.2 ± 22.3 min), and experts (46.8 ± 19.9 min). Internal consistency was high between the GRS and STS subscores for both direct and video OSATS with Cronbach's α of 0.76 and 0.86, respectively. Video OSATS and operative time in combination was a better predictor of direct OSATS than each single parameter. Conclusion: Direct OSATS rating was better than endoscopic video rating for differentiating between students or novices and experts for LC and should remain the standard approach for the discrimination of experience levels. However, in the absence of experts for direct rating, video OSATS supplemented with operative time should be used instead of single parameters for predicting direct OSATS scores.

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“…Observational studies [29][30][31] Novices can see specifically where they need to improve their skills technical experience, however, learning on higher-fidelity models (i.e., animal or cadaveric) appear to result in greater improvement in technical proficiency compared with training on low-fidelity models. 46 These studies illustrate that inexpensive, reliable and valid models exist that are equivalent to animal or cadaveric models for training novice surgeons.…”

Section: Analysis Of Dexteritymentioning

confidence: 99%

Simulation in surgical education

Palter

Grantcharov²

2010

Canadian Medical Association Journal

121

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Key points• Both technical and non-technical skills are essential for surgeons in training.• Technical skills learned on low-fidelity benchtop models, video-based trainers and virtual-reality models are transferable to the operating room.• Current evidence does not show a clear advantage of either virtual reality or synthetic models in teaching technical skills.• Evidence is lacking on how best to integrate each type of simulator into a holistic, proficiency-based curriculum. Simulation in surgical educationVanessa N. Palter MD, Teodor P. Grantcharov MD PhDPreviously published at www.cmaj.caReview those used for teaching minimally invasive procedures (referred to as tower trainers or video-box trainers). Numerous benchtop models are available for the simulation of a variety of procedures, including knot-tying, fascial closure, and suturing 14 (Figure 1). The most obvious limitation of such models is that they teach only one surgical technique rather than an entire operation. 5 Their use requires the presence of an expert to demonstrate the procedure and provide feedback on performance. 1,5 Tower trainers include a box with slits on the superior surface for trocar insertion. Real laparoscopic instruments are inserted through the trocars into the box, where the procedure is simulated. A camera inside the box provides video output to a monitor on which trainees can watch their own movements. These models can simulate a variety of techniques, including laparoscopic suturing, knot-tying, clip-applying and coordination drills.14 One of the most well-described tower trainers is the physical laparoscopy trainer known as the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills. This system consists of five tasks performed on an endotrainer box. 16 The tasks include peg transfer, cutting, placing a ligating loop and intracorporeal suturing. Virtual-reality simulationTraining by virtual-reality simulation encompasses systems designed to teach laparoscopic, endoscopic and percutaneous interventions. 13 The fidelity of virtual-reality simulators ranges widely, from the Minimally Invasive Surgical Trainer -Virtual Reality (MIST-VR) system, which is a low-fidelity system designed to teach general laparoscopic proficiency, to systems that teach component procedural skills and other systems that replicate entire operations 17 ( Figure 2 and Videos 1 and 2, available at www .cmaj .ca /cgi /content /full /cmaj .091743 /DC1). Unlike bench-model learning, the presence of an expert is not necessary when virtual-reality simulation is used. Such models allow for practice at varying levels of difficulty, can simulate complications and automatically provide objective measures of assessment, allowing for both formative and summative trainee assessment.18 Virtual-reality models have been criticized, however, for high initial cost of system acquisition, limited force-feedback with use of surgical instruments and lack of realism of graphics. 14,19The virtual operating room Benchtop models, virtual-reality models, and an...

show abstract

Development of assessing generic and specific technical skills in laparoscopic surgery

Cited by 51 publications

References 12 publications

A decision-making learning and assessment tool in laparoscopic cholecystectomy

A decision-making learning and assessment tool in laparoscopic cholecystectomy

Direct Observation versus Endoscopic Video Recording-Based Rating with the Objective Structured Assessment of Technical Skills for Training of Laparoscopic Cholecystectomy

Simulation in surgical education

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