An Assessment Tool to Provide Targeted Feedback to Robotic Surgical Trainees: Development and Validation of the End-to-End Assessment of Suturing Expertise (EASE)

Abstract

Introduction:We created a suturing skills assessment tool that comprehensively defines criteria around relevant subskills of suturing and confirmed its validity.Methods: Five expert surgeons and an educational psychologist participated in a cognitive task analysis to deconstruct robotic suturing into an exhaustive list of technical skill domains and subskill descriptions. Using the Delphi methodology, each cognitive task analysis element was systematically reviewed by a multi-institutional panel of 16 surgical educators and implemented in the final product when content validity index reached !0.80. In the subsequent validation phase, 3 blinded reviewers independently scored 8 training videos and 39 vesicourethral anastomoses using EASE (End-to-End Assessment of Suturing Expertise); 10 vesicourethral anastomoses were also scored using RACE (Robotic Anastomosis Competency Evaluation), a previously validated but simplified suturing assessment tool. Inter-rater reliability was measured with intra-class correlation for normally distributed values and prevalence-adjusted bias-adjusted Kappa for skewed distributions. Expert (!100 prior robotic cases) and trainee (<100 cases) EASE scores from the non-training cases were compared using a generalized linear mixed model.

A vision transformer for decoding surgeon activity from surgical videos

“…The needle handling and needle driving subphases can also be evaluated on the basis of the skill level with which they are executed. In our previous work, we developed a taxonomy 46 enabling us to annotate any suturing subphase with a binary skill level (low skill versus high skill).…”

“…and others) with surgical subphases and skills. This annotation followed the strict guidelines of our previously developed taxonomy referred to as the end-to-end assessment of suturing expertise or EASE 46 . Since the VUA step is a reconstructive one in which the bladder and urethra are joined together, it often requires a series of stitches (on the order of 24 stitches: 12 on the bladder side and another 12 on the urethral side).…”

Simulation training in urology

“…One crucial component of high-quality simulation is objective assessment and structured feedback. Numerous assessment tools, both general and procedure-specific, have been crafted [38 ▪ ,39,40]. Traditionally, the use of these tools necessitates the examination of surgical videos by experts, a process that is labor-intensive and restricts their widespread application in training programs.…”