Competency assessment tool for laparoscopic suturing: development and reliability evaluation

IJgosse, Wouter; Leijte, Erik; Ganni, Sandeep; Luursema, Jan-Maarten; Francis, Nader; Jakimowicz, Jack J.; Botden, Sanne M. B. I.

doi:10.1007/s00464-019-07077-2

Cited by 28 publications

(22 citation statements)

References 24 publications

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“…Overall, this CAT-PSARP had slightly lower inter-observer reliability scores compared to the other previously developed CAT's [13,[15][16][17]. There are several possible explanations for this.…”

mentioning

confidence: 74%

“…The CAT-PSARP was developed with a structured approach, based on the previously developed CAT's [13,[15][16][17]. The focus of this CAT-PSARP form is on the performance of each step as well as the general skills separately.…”

Section: Development Of the Cat-psarpmentioning

confidence: 99%

“…The CAT has been successfully applied to improve the quality of training in the English National Training Program for laparoscopic colorectal surgery [15]. It has also been further developed and used for the assessment of the laparoscopic cholecystectomy [13,16] and for laparoscopic suturing [17].…”

Section: Introductionmentioning

confidence: 99%

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Validation of a newly developed competency assessment tool for the Posterior Sagittal Anorectoplasty

Joosten¹,

Bökkerink

Sutcliffe

et al. 2020

Preprint

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Background: The correction of an anorectal malformation (ARM) is highly complex and relatively infrequent. Simulation training and subsequent assessment of its effectiveness may result in better clinical outcomes. Assessment can be done using a CAT to assess surgical skills of a specific procedure. This study aims to develop and validate a competency assessment tool (CAT) for the posterior sagittal anorectoplasty (PSARP) for the repair of anorectal malformation. Methods: The CAT-PSARP was developed after consultation with experts in the field. The PSARP was divided into five steps, while general skills (tissue and instrument handling) were scored separately. During several pediatric colorectal hands-on courses in 2019 and 2020 participants were asked to voluntarily participate. They performed one PSARP procedure on an ARM simulation model, while being assessed by two objective observers using the CAT-PSARP.Results: A total of 82 participants were enrolled. Intra-class correlation coefficient analysis demonstrated a fair inter-observer agreement for ‘total score of general skills’ (ICC =0.524, p<0.001), a good agreement for ‘total score of specific skills’ (ICC=0.646 , p<0.001) and ‘total score overall’ (ICC=0.669, p<0.001). When comparing the experienced with the inexperienced group a significantly higher score for the experienced group was found for all steps (p=0.013 to p<0.001), except for step 5 ‘anoplasty’ (p=0.440). Conclusion: Good inter-observer agreement was found for the total scores of the CAT-PSARP. It is a suitable objective assessment tool for the overall performance of the included steps of the PSARP for repair of an ARM.

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mentioning

confidence: 74%

Section: Development Of the Cat-psarpmentioning

confidence: 99%

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Validation of a newly developed competency assessment tool for the Posterior Sagittal Anorectoplasty

Joosten¹,

Bökkerink

Sutcliffe

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…the Objective Structured Assessment of Technical Skills-OSATS) [ 27 ]; however, this is usually less applicable in minimally invasive interventions. For dry-lab laparoscopic training sessions, MISTELS and Laparoscopic Suturing Competency Assessment Tool scores are probably more adequate tools [ 15 , 28 ], while the GOALS score appears to be an appropriate approach for both basic and complex interventions [ 29 ]. It enables assessors not only to classify surgeons based on their technical performance (detailed in the Methods section) [ 17 , 25 ], but also to compare advancement in different training groups [ 12 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair

et al. 2021

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Background Laboratory skills training is an essential step before conducting minimally invasive surgery in clinical practice. Our main aim was to develop an animal model for training in clinically highly challenging laparoscopic duodenal atresia repair that could be useful in establishing a minimum number of repetitions to indicate safe performance of similar interventions on humans. Materials and methods A rabbit model of laparoscopic duodenum atresia surgery involving a diamond-shaped duodeno-duodenostomy was designed. This approach was tested in two groups of surgeons: in a beginner group without any previous clinical laparoscopic experience (but having undergone previous standardized dry-lab training, n = 8) and in an advanced group comprising pediatric surgery fellows with previous clinical experience of laparoscopy (n = 7). Each participant performed eight interventions. Surgical time, expert assessment using the Global Operative Assessment of Laparoscopic Skills (GOALS) score, anastomosis quality (leakage) and results from participant feedback questionnaires were analyzed. Results Participants in both groups successfully completed all eight surgeries. The surgical time gradually improved in both groups, but it was typically shorter in the advanced group than in the beginner group. The leakage rate was significantly lower in the advanced group in the first two interventions, and it reached its optimal level after five operations in both groups. The GOALS and participant feedback scores showed gradual increases, evident even after the fifth surgery. Conclusions Our data confirm the feasibility of this advanced pediatric laparoscopic model. Surgical time, anastomosis quality, GOALS score and self-assessment parameters adequately quantify technical improvement among the participants. Anastomosis quality reaches its optimal value after the fifth operation even in novice, but uniformly trained surgeons. A minimum number of wet-lab operations can be determined before surgery can be safely conducted in a clinical setting, where the development of further non-technical skills is also required.

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Section: Introductionmentioning

confidence: 99%

Validation of a Newly Developed Competency Assessment Tool for the Posterior Sagittal Anorectoplasty

et al. 2021

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Introduction The correction of an anorectal malformation (ARM) is complex and relatively infrequent. Simulation training and subsequent assessment may result in better clinical outcomes. Assessment can be done using a competency assessment tool (CAT). This study aims to develop and validate a CAT for the posterior sagittal anorectoplasty (PSARP) on a simulation model. Materials and Methods The CAT-PSARP was developed after consultation with experts in the field. The PSARP was divided into five steps, while tissue and instrument handling were scored separately. Participants of pediatric colorectal hands-on courses in 2019 and 2020 were asked to participate. They performed one PSARP procedure on an ARM simulation model, while being assessed by two objective observers using the CAT-PSARP. Results A total of 82 participants were enrolled. A fair interobserver agreement was found for general skills (intraclass correlation coefficient [ICC] = 0.524, p < 0.001), a good agreement for specific skills (ICC = 0.646, p < 0.001), and overall performance (ICC = 0.669, p < 0.001). The experienced group scored higher on all steps (p < 0.001), except for “anoplasty (p = 0.540),” compared with an inexperienced group. Conclusion The CAT-PSARP is a suitable objective assessment tool for the overall performance of the included steps of the PSARP for repair of an ARM on a simulation model.

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Competency assessment tool for laparoscopic suturing: development and reliability evaluation

Cited by 28 publications

References 24 publications

Validation of a newly developed competency assessment tool for the Posterior Sagittal Anorectoplasty

Validation of a newly developed competency assessment tool for the Posterior Sagittal Anorectoplasty

Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair

Validation of a Newly Developed Competency Assessment Tool for the Posterior Sagittal Anorectoplasty

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