Validation of a Novel Simulation-Based Test in Robot-Assisted Radical Prostatectomy

Olsen, Rikke Groth; Bjerrum, Flemming; Konge, Lars; Jepsen, Jan V.; Azawi, Nessn; Bube, Sarah

doi:10.1089/end.2020.0986

Cited by 9 publications

(9 citation statements)

References 28 publications

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“…Most often, medical students represented novices, residents or interns were often considered intermediates, and surgeons or consultants were considered as experienced. Some studies defined the experience and competency of the participants by the number of procedures performed, such as defining the experienced participants as having performed more than 50 procedures in real life 27–40 …”

Section: Resultsmentioning

confidence: 99%

“…Some studies defined the experience and competency of the participants by the number of procedures performed, such as defining the experienced participants as having performed more than 50 procedures in real life. [27][28][29][30][31][32][33][34][35][36][37][38][39][40] Some of the included studies categorized participants both by career stage and number of procedures, which led to changes in the numbers of participants in the study groups: 37,39,41 -51 Chen et al for example included a total of 50 participants (11 faculty and 39 trainees) but when divided into experienced and inexperienced based on the previous number of procedures performed, the experienced group included faculty as well as post-graduate-year 4 and 5 trainees 41 ; Conversely, Dioun et al 42 included 14 fellows and 12 faculty who actually represented 6 experienced, 18 novices, and 2 participants of unknown experience with robotic surgery.…”

Section: Participantsmentioning

confidence: 99%

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Standard Setting in Simulation-based Training of Surgical Procedures

et al. 2021

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Objective: This systematic review aims to examine the use of standardsetting methods in the context of simulation-based training of surgical procedures. Summary of background: Simulation-based training is increasingly used in surgical education. However, it is important to determine which level of competency trainees must reach during simulation-based training before operating on patients. Therefore, pass/fail standards must be established using systematic, transparent, and valid methods. Methods: Systematic literature search was done in 4 databases (Ovid MED-LINE, Embase, Web of Science, and Cochrane Library). Original studies investigating simulation-based assessment of surgical procedures with the application of a standard setting were included. Quality of evidence was appraised using GRADE. Results: Of 24,299 studies identified by searches, 232 studies met the inclusion criteria. Publications using already established standard settings were excluded (N ¼ 70), resulting in 162 original studies included in the final analyses. Most studies described how the standard setting was determined (N ¼ 147, 91%) and most used the mean or median performance score of experienced surgeons (n ¼ 65, 40%) for standard setting. We found considerable differences across most of the studies regarding study design, setup, and expert level classification. The studies were appraised as having low and moderate evidence. Conclusion: Surgical education is shifting toward competency-based education, and simulation-based training is increasingly used for acquiring skills and assessment. Most studies consider and describe how standard settings are established using more or less structured methods but for current and future educational programs, a critical approach is needed so that the learners receive a fair, valid, and reliable assessment.

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Section: Resultsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Standard Setting in Simulation-based Training of Surgical Procedures

et al. 2021

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“…This research group found a simulator score based on performance during bladder neck dissection, neurovascular bundle dissection and ureterovesical anastomosis that predicts experience levels of surgeons. According to the authors this score might be used to define which surgeon can proceed to supervised clinical training [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of New Imaging Technologies for Robotic Prostatectomy: From Molecular Imaging to Augmented Reality

Rodler,

Kidess,

Westhofen

et al. 2023

JCM

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New imaging technologies play a pivotal role in the current management of patients with prostate cancer. Robotic assisted radical prostatectomy (RARP) is a standard of care for localized disease and through the already imaging-based console subject of research towards combinations of imaging technologies and RARP as well as their impact on surgical outcomes. Therefore, we aimed to provide a comprehensive analysis of the currently available literature for new imaging technologies for RARP. On 24 January 2023, we performed a systematic review of the current literature on Pubmed, Scopus and Web of Science according to the PRISMA guidelines and Oxford levels of evidence. A total of 46 studies were identified of which 19 studies focus on imaging of the primary tumor, 12 studies on the intraoperative tumor detection of lymph nodes and 15 studies on the training of surgeons. While the feasibility of combined approaches using new imaging technologies including MRI, PSMA-PET CT or intraoperatively applied radioactive and fluorescent dyes has been demonstrated, the prospective confirmation of improvements in surgical outcomes is currently ongoing.

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“…Experienced participants performed significantly better than novices in both procedures. However, physicians performed about the same as the intermediates, which may indicate that the simulator cannot discriminate the small nuances in the lumbar puncture procedure, a problem also reported with a VR simulator for robot-assisted radical prostatectomy [ 19 ]. However, our simulation-based test possessed discriminatory ability as opposed to a test using a virtual reality simulator of uretero-nephroscopy, which could not even discriminate between novices and experts [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Using a novel virtual-reality simulator to assess performance in lumbar puncture: a validation study

Xie,

Grimstrup,

Nayahangan

et al. 2023

BMC Med Educ

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Background A lumbar puncture procedure’s success depends on a competent physician minimizing the risk of failing to get a sample and avoiding complications such as post-dural headache. A new virtual-reality simulator might be helpful in deciding when a physician is competent to perform lumbar puncture. We aimed to investigate validity evidence for a simulator-based test in lumbar puncture and establish a pass/fail standard to allow a mastery learning training program. Methods Validity evidence was investigated using Messick’s framework by including participants who were novices, intermediates, or experienced in lumbar puncture. Each participant performed two lumbar puncture procedures on the simulator, and fifty-nine predefined simulator metrics were automatically recorded. Cronbach’s alpha was used to explore internal consistency reliability. Intergroup comparisons were made using independent sample t-tests with Tukey’s correction for multiple comparisons. The learning effect was explored using paired sample t-test analysis, and a pass/fail standard was established using the contrasting groups’ method. Results 73 novices, 18 intermediates, and 19 physicians performed the test resulting in a total of 220 procedures. 25 metrics (42.4%) had good discriminatory ability, and the reliability of these metrics was good, Cronbach’s α = 0.81. The experienced physicians were significantly better than the novices (18.3 vs. 13.3, p < 0.001), and the pass/fail standard was established at 16 points. This standard resulted in 22 (30.1%) novices passing (i.e., false positives) and 5 (26.3%) physicians failing (i.e., false negatives). Conclusion This study provides validity evidence for a simulator-based test of lumbar puncture competence. The test can help ensure basic competence at the end of a simulation-based training program for trainees, i.e., a mastery learning training program.

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Validation of a Novel Simulation-Based Test in Robot-Assisted Radical Prostatectomy

Cited by 9 publications

References 28 publications

Standard Setting in Simulation-based Training of Surgical Procedures

Standard Setting in Simulation-based Training of Surgical Procedures

A Systematic Review of New Imaging Technologies for Robotic Prostatectomy: From Molecular Imaging to Augmented Reality

Using a novel virtual-reality simulator to assess performance in lumbar puncture: a validation study

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