Validation of an endoscopic flavectomy training model

Abstract

Objective: to validate a lumbar spine endoscopic flavectomy simulator using the construct method and to assess the acceptability of the simulator in medical education. Methods: thirty medical students and ten video-assisted surgery experienced orthopedists performed an endoscopic flavectomy procedure in the simulator. Time, look-downs, lost instruments, respect for the stipulated edge of the ligamentum flavum, regularity of the incision, GOALS checklist (Global Operative Assessment of Laparoscopic Skills), and responses to the Likert Scale adapted for this study were analyzed. Results: all variables differed between groups. Procedure time was shorter in the physician group (p < 0.001). Look-downs and instrument losses were seven times greater among students than physicians. Half of the students respected the designated incision limits, compared to 80% of the physicians. In the student group, about 30% of the incisions were regular, compared to 100% in the physician group (p < 0.001). The physicians performed better in all GOALS checklist domains. All the physicians and more than 96% of the students considered the activity enjoyable, and approximately 90% believed that the model was realistic and could contribute to medical education. Conclusions: the simulator could differentiate the groups’ experience level, indicating construct validity, and both groups reported high acceptability.

Education for Being A Spine Endoscopic Surgeon: What Matters?

“…This conveyed an vital message to organizations and manufactures who are dedicated to promote the technique and help the less-experienced surgeons. Even though cadavers are not always available especially for some regions, it is joyful to see some innovative alternative training program has been come up by peers [23][24]. This trend is in line with the survey and it should be continually pushed forward to make our efforts comes in.…”

Training to be a spinal endoscopic surgeon: What matters?

“…This conveyed a vital message to organizations and manufacturers who are dedicated to promoting the technique and helping less-experienced surgeons. Even though cadavers are not always available, especially in some regions, it is satisfying to see peers develop innovative alternative training programs ( 23 , 24 ). This trend is in line with the survey, and it should be maintained for our efforts to be worthwhile.…”

Validação de constructo e experiência de uso de um simulador de artroscopia de ombro de baixo custo

“…22 For a more objective evaluation of the results, it was decided to use the GOALS score, which, despite having been created to evaluate laparoscopic surgeries, 18 had already been used in the evaluation of a shoulder arthroscopy simulator and a training model in flavectomy endoscopic. 15,28 To be as objective as possible, we created a scale of time or number of attempts to perform specific tasks and correlated it with each item of the GOALS score and in the intergroup comparison we observed differences between all groups in the first test. The same results were observed in the second test comparing surgeons and residents, but not when comparing residents and students.…”

“…21 The item with the greatest disagreement was whether the simulator could replace cadaver training, with 30% of disagreement between surgeons and residents, while 20% of students disagreed, corresponding to the findings of other authors. 28,30 The cadaver remains the gold standard for simulation, providing identical anatomy, similar tactile sensation, limited only by the lack of bleeding and active muscle contraction.…”

“…21 O item com maior discordância foi se o simulador poderia substituir o treinamento em cadáveres com, 30% de discordância entre os cirurgiões e residentes, enquanto 20% dos estudantes discordaram, correspondendo aos achados de outros autores. 28,30 O cadáver continua sendo o padrãoouro para simulação, proporcionando anatomia idêntica, sensação tátil semelhante, limitada apenas pela falta de sangramento e contração muscular ativa.…”