Superficial Temporal Artery–Middle Cerebral Artery Bypass Ex Vivo Hybrid Simulator: Face, Content, Construct, and Concurrent Validity

Ferrarez, Carlos Eduardo; Bertani, Raphael; Batista, Doralice M. Leite; Lovato, Renan Maximilian; Perret, Caio; Abi-Aad, Karl R.; Oliveira, Marcelo Magaldi; Cannizzaro, Bruno; Costa, Pollyanna H. Vieira; Silveira, Roberto Leal; Kill, Cleverson Martins; Gusmão, Sebastião

doi:10.1016/j.wneu.2020.07.027

Cited by 9 publications

(6 citation statements)

References 14 publications

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“…Instrument tacking technology can potentially be applied to all previously described ex vivo simulation models that utilize real surgical instruments. 44,45,[53][54][55] The third objective of this study was to demonstrate if significant differences in face and content validity between skilled and less skilled participants was present during the performance of the ex vivo corticectomy subpial resection model. Assessment of a simulator's face and content validity is traditionally performed by experts, however, we sought to investigate the assessment of individuals who are in their advanced stages of training (senior resident and fellows).…”

Section: Thesis Discussionmentioning

confidence: 99%

“…51,52 Placenta models have been utilized in recreating brain tumor resections, aneurysm clipping and vascular anastomosis. [53][54][55] However, placentas are not readily available and pose a supply challenge when needed for everyday training. In cerebrovascular neurosurgery, with the improved ability of minimally invasive endovascular techniques, open surgical clipping is not as common, however, continuity in training such skills is imperative, as a subset of cases still require open surgical interventions.…”

Section: Simulation In Neurosurgery and Ex Vivo Modelsmentioning

confidence: 99%

“…Three main validation metrics used in the initial process are: face, content, and construct validation. 43,44,[51][52][53]55 Each metric tests the simulator's ability in representing what the tool was intended to simulate. Face validation is a qualitative assessment by experts to determine whether the simulator shares visual and tactile realism with real-world operations it aims to recreate.…”

Section: Simulator Validationmentioning

confidence: 99%

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Continuous Instrument Tracking in a Cerebral Corticectomy Ex Vivo Calf Brain Simulation Model: Face and Content Validation

Almansouri,

Abou Hamdan,

Yilmaz

et al. 2024

Operative Neurosurgery

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BACKGROUND AND OBJECTIVES: Subpial corticectomy involving complete lesion resection while preserving pial membranes and avoiding injury to adjacent normal tissues is an essential bimanual task necessary for neurosurgical trainees to master. We sought to develop an ex vivo calf brain corticectomy simulation model with continuous assessment of surgical instrument movement during the simulation. A case series study of skilled participants was performed to assess face and content validity to gain insights into the utility of this training platform, along with determining if skilled and less skilled participants had statistical differences in validity assessment. METHODS: An ex vivo calf brain simulation model was developed in which trainees performed a subpial corticectomy of three defined areas. A case series study assessed face and content validity of the model using 7-point Likert scale questionnaires. RESULTS: Twelve skilled and 11 less skilled participants were included in this investigation. Overall median scores of 6.0 (range 4.0-6.0) for face validity and 6.0 (range 3.5-7.0) for content validity were determined on the 7-point Likert scale, with no statistical differences between skilled and less skilled groups identified. CONCLUSION: A novel ex vivo calf brain simulator was developed to replicate the subpial resection procedure and demonstrated face and content validity.

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Section: Thesis Discussionmentioning

confidence: 99%

Section: Simulation In Neurosurgery and Ex Vivo Modelsmentioning

confidence: 99%

Section: Simulator Validationmentioning

confidence: 99%

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Continuous Instrument Tracking in a Cerebral Corticectomy Ex Vivo Calf Brain Simulation Model: Face and Content Validation

Almansouri,

Abou Hamdan,

Yilmaz

et al. 2024

Operative Neurosurgery

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“…Hence, the microanastomosis simulation using these models has high face, content, and construct validities ( 1 ). In 2020, Ferrarez et al described a superficial temporal artery-middle cerebral artery bypass training simulator placing a human placenta in an artificial skull in which a fronto-temporal approach had been previously performed ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

A novel, reusable, realistic neurosurgical training simulator for cerebrovascular bypass surgery: Iatrotek® bypass simulator validation study and literature review

D'Andrea

Musio²,

Colasanti³

et al. 2023

Front. Surg.

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BackgroundMicroanastomosis is a challenging technique requiring continuous training to be mastered. Several models have been proposed, but few effectively reflect a real bypass surgery; even fewer are reusable, most are not easily accessible, and the setting is often quite long. We aim to validate a simplified, ready-to-use, reusable, ergonomic bypass simulator.MethodsTwelve novice and two expert neurosurgeons completed eight End-to-End (EE), eight End-to-Side (ES), and eight Side-to-Side (SS) microanastomoses using 2-mm synthetic vessels. Data on time to perform bypass (TPB), number of sutures and time required to stop potential leaks were collected. After the last training, participants completed a Likert Like Survey for bypass simulator evaluation. Each participant was assessed using the Northwestern Objective Microanastomosis Assessment Tool (NOMAT).ResultsWhen comparing the first and last attempts, an improvement of the mean TPB was registered in both groups for the three types of microanastomosis. The improvement was always statistically significant in the novice group, while in the expert group, it was only significant for ES bypass. The NOMAT score improved in both groups, displaying statistical significance in the novices for EE bypass. The mean number of leakages, and the relative time for their resolution, also tended to progressively reduce in both groups by increasing the attempts. The Likert score expressed by the experts was slightly higher (25 vs. 24.58 by the novices).ConclusionsOur proposed bypass training model may represent a simplified, ready-to-use, reusable, ergonomic, and efficient system to improve eye-hand coordination and dexterity in performing microanastomoses.

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“…As open surgical and endovascular procedures in combination with different intraoperative imaging modalities become increasingly complex, standardized step-by-step simulations on lifelike models have become an increasingly important part of surgical training [ 18 ]. During the last decade, several simulation models have been developed, including a hybrid procedure suite, a hybrid ex vivo placenta-human skull simulator for cerebral bypass training, a live tissue simulator hybrid porcine model for REBOA placement and lifelike pulsatile flow models [ 19 , 20 , 21 , 22 ]. All settings have the aim to increase the confidence of the surgeon in a safe environment without mitigating patient safety in common.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation Simulation Training in a Lifelike Flow Model

et al. 2022

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Objectives: To assess the feasibility and training effect of simulation training for ultrasound-guided percutaneous arteriovenous fistula (pAVF) creation in a lifelike flow model. Methods: Twenty vascular trainees and specialists were shown an instructional video on creating a pAVF in a dedicated flow model and then randomized to a study or control group. The procedure was divided into five clearly defined steps. Two observers rated the performance on each step, and the time to perform the exercise was recorded. The study group participants underwent supervised hands-on training on the model before performing a second rated pAVF creation. All participants subsequently completed a feedback questionnaire. Results: After supervised simulation training, the study groups participants increased their mean performance rating from 2.2 ± 0.9 to 3.2 ± 0.7. A mean of 3.8 ± 0.8 procedure steps was accomplished independently (control group 2.1 ± 1.4; p < 0.05). The time taken to perform the procedure was 15.6 ± 3.8 min in the study group (control group 27.2 ± 7.3, p < 0.05). The participants with previous experience in ultrasound-guided vascular procedures (n = 5) achieved higher overall mean scores 3.0 ± 0.8 and accomplished more steps without assistance (2.0 ± 1.0) during the simulation training compared to their inexperienced peers (1.5 ± 0.3 and 0.8 ± 0.4, respectively). The feedback questionnaire revealed that the study group participants strongly agreed (n = 7) or agreed (n = 3) that training on the simulation model improved their skills regarding catheter handling. Conclusions: The study group participants increased their overall performance after training on the simulator. More experienced attendees performed better from the beginning, indicating the model to be lifelike and a potential skill assessment tool. Simulation training for pAVF creation using a lifelike model may be an intermediate step between acquiring ultrasound and theoretical pAVF skills and procedure guidance in theatre. However, this type of training is limited by its reliance on the simulator quality, demonstration devices and costs.

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Superficial Temporal Artery–Middle Cerebral Artery Bypass Ex Vivo Hybrid Simulator: Face, Content, Construct, and Concurrent Validity

Cited by 9 publications

References 14 publications

Continuous Instrument Tracking in a Cerebral Corticectomy Ex Vivo Calf Brain Simulation Model: Face and Content Validation

Continuous Instrument Tracking in a Cerebral Corticectomy Ex Vivo Calf Brain Simulation Model: Face and Content Validation

A novel, reusable, realistic neurosurgical training simulator for cerebrovascular bypass surgery: Iatrotek® bypass simulator validation study and literature review

Ultrasound-Guided Percutaneous Arteriovenous Fistula Creation Simulation Training in a Lifelike Flow Model

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