Development and validation of surgical training tool: cystectomy assessment and surgical evaluation (CASE) for robot-assisted radical cystectomy for men

Hussein, Ahmed A.; Sexton, Kevin; May, Paul; Meng, Maxwell V.; Hosseini, Abolfazl; Eun, Daniel; Daneshmand, Siamak; Bochner, Bernard H.; Peabody, James O.; Abaza, Ronney; Skinner, Eila C.; Hautmann, Richard E.; Guru, Khurshid A.

doi:10.1007/s00464-018-6191-3

Cited by 15 publications

(5 citation statements)

References 26 publications

(33 reference statements)

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“…To assess robot-assisted radical cystectomy (RARC) surgical competence, Hussein et al developed and validated the CASE (Cystectomy Assessment and Surgical Evaluation) in 2018. 30 It divided RARC into 8 key steps, which are each rated on a 1-5 Likert scale. This structure provides a platform for formalized feedback of surgical performance during RARC and can be used to monitor progression of skill throughout training.…”

Section: Resultsmentioning

confidence: 99%

Current Landscape of Surgical Assessment Models in Urology Residency Training

et al. 2023

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Purpose:Assessing trainees’ surgical proficiency is an important aspect of urological surgical training. The current standard is the Urology Milestone Project, initially implemented in 2013. This evaluation is limited in that it contains only 3 questions on surgical competency per surgical modality with assessments occurring semi-annually without real-time operative feedback. However, since the Urology Milestones Project’s inception a plethora of competency-based surgical assessment tools have been described. We aim to perform a comprehensive review of the literature of these available tools and analyze their strengths and weaknesses as a way of providing a repository of available assessment strategies for further development of a more comprehensive and standardized assessment tool.Materials and Methods:A review of the primary literature was performed using key words such as “surgical assessment tools urology,” “surgical assessment tools prostate,” “bladder surgical assessment tools,” “renal surgical assessment tools urology,” and “surgical assessment tools urology task specific.” Technical and nontechnical skill assessments were included. One reviewer identified and analyzed studies that published assessment tools for use in surgical and urological training.Results:A total of 1,497 articles published between 1997-2022 were identified. Of these, 34 met the inclusion criteria. Eighteen (52.9%) were specialty nonspecific and 16 (47.1%) were specific for urological training. Of the 18 tools developed for general surgical principles, 12 (66.7%) had some form of validity, 9 (50.0%) were significantly reliable, and 2 (11.1%) were externally validated. Of the 16 tools developed specifically for use in urology training, 13 (81.3%) had some form of validity, 7 (43.8%) were significantly reliable, and none were externally validated. Of these 16 tools, 12 (75.0%) were procedure-specific and 4 (25.0%) were developed for general use in endourological procedures.Conclusions:Surgical training is evolving toward a competency-based model, as evidenced by the increase in assessment tools created within the past 10 years. These instruments not only provide objective feedback to trainees, but also monitor progression. However, they are heterogeneous in construct and utilization. There remains a need for the adoption of a standardized, valid, and reliable tool, ie, both procedure-specific and generalizable across multiple procedures for use in urology training.

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Section: Resultsmentioning

confidence: 99%

Current Landscape of Surgical Assessment Models in Urology Residency Training

et al. 2023

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“…Of all the metrics identified in this review; the majority were specific to urology; the Prostatectomy Assessment Competency Evaluation (PACE) score, Robotic Assessment Radical Prostatectomy (RARP) score and the Cystectomy Assessment and Surgical Evaluation (CASE) score [39][40][41]. However, these metrics relied upon subjective measures of assessment.…”

Section: Procedural Specific Metricsmentioning

confidence: 99%

Measures of performance and proficiency in robotic assisted surgery: a systematic review

El-Sayed,

Yiu,

Burke

et al. 2024

J Robotic Surg

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Background: Robotic Assisted Surgery (RAS) has seen a global rise in adoption. Despite this, there is not a standardised training curricula nor a standardised measure of performance.We performed a systematic review across the surgical-specialties in RAS and evaluated tools used to assess surgeon's technical performance.Methods: Using the PRISMA 2020 guidelines, Pubmed, Embase and the Cochrane Library were searched systematically for full texts published on or after January 2020 -January 2022. Observational studies and RCTs were included; review articles and systematic reviews were excluded. The papers' quality and bias score were assessed using the Newcastle Ottawa Score for the observational studies and Cochrane Risk Tool for the RCTs.Results: The initial search yielded 1189 papers of which 72 fit the eligibility criteria. 27 unique performance metrics were identified. Global assessments were the most common tool of assessment (n=13); the most used was GEARs (Global Evaluative Assessment of Robotic Skills). 11 metrics (42%) were objective tools of performance. Automated performance metrics (APMs) were the most widely used objective metrics whilst the remaining (n=15, 58%) were subjective. Conclusion:The results demonstrate variation in tools used to assess technical performance in RAS. A large proportion of the metrics are subjective measures which increases the risk of bias amongst users. A standardised objective metric which measures all domains of technical performance from global to cognitive is required. The metric should be applicable to all RAS procedures and easily implementable. Automated performance metrics (APMs) have demonstrated promise in their wide use of accurate measures.

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“…Cystectomy Assessment and Surgical Evaluation (CASE) evaluates the surgical technique for cystectomy in an objective way based on expert consensus on what defines surgical proficiency [150]. Eight domains of the CASE included pelvic LND, development of the periureteral space, lateral pelvic space, anterior rectal space, control of the vascular pedicle, anterior vesical space, control of the dorsal venous complex, and apical dissection.…”

Section: 4mentioning

confidence: 99%

Quality Indicators for Bladder Cancer Services: A Collaborative Review

et al. 2020

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Context: There is a lack of accepted consensus on what should constitute appropriate quality-of-care indicators for bladder cancer. Objective: To evaluate the optimal management of bladder cancer and propose quality indicators (QIs). Evidence acquisition: A systematic review was performed to identify literature on current optimal management and potential quality indicators for both non-muscleinvasive (NMIBC) and muscle-invasive (MIBC) bladder cancer. A panel of experts was

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Development and validation of surgical training tool: cystectomy assessment and surgical evaluation (CASE) for robot-assisted radical cystectomy for men

Abstract: We developed and validated a reliable structured, procedure-specific tool for objective evaluation of surgical performance during RARC. CASE may help differentiate novice from expert performances.

Cited by 15 publications

References 26 publications

Current Landscape of Surgical Assessment Models in Urology Residency Training

Current Landscape of Surgical Assessment Models in Urology Residency Training

Measures of performance and proficiency in robotic assisted surgery: a systematic review

Quality Indicators for Bladder Cancer Services: A Collaborative Review

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