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Published in: Surgical Endoscopy 11/2004

01-11-2004 | Original article

Bimodal assessment of laparoscopic suturing skills: Construct and concurrent validity

Authors: K. Moorthy, Y. Munz, A. Dosis, F. Bello, A. Chang, A. Darzi

Published in: Surgical Endoscopy | Issue 11/2004

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Abstract

Background

The assessment of technical skills should provide objective feedback and judge suitability of progress during training. The aim of this study was to validate two objective assessment techniques for laparoscopic suturing and demonstrate a correlation between them.

Methods

Six experts, seven surgeons skilled in laparoscopic suturing, and 13 with no laparoscopic suturing skills were asked to place two or three intracorporeal sutures on a synthetic suture pad. The latter group was given video-based instructions prior to the execution of the sutures. Ergonomic conditions were standardized for all subjects. The procedures were recorded on videotape and two blinded observers rated the first suture of each subject on a 29-point checklist. A motion analysis system, Imperial College Surgical Assessment Device, was used to assess psychomotor skills.

Results

There was a significant difference in the time taken (p = 0.000) and total path length (p = 0.000) per suture across the groups. There were also a significant difference in the total checklist score (p = 0.000) and its individual categories. The was a strong correlation between the total path length and the total checklist score (coefficient, 0.78; p < 0.001).

Conclusions

A combination of the motion analysis system and the checklist would make the process of formative feedback during the learning of intracorporeal suturing objective and comprehensive.
Literature
1.
go back to reference Cagir, B, Rangraj, M, Maffuci, L, Herz, BL 1994The learning curve for laparoscopic cholecystectomyJ Laparoendosc Surg4419427PubMed Cagir, B, Rangraj, M, Maffuci, L, Herz, BL 1994The learning curve for laparoscopic cholecystectomyJ Laparoendosc Surg4419427PubMed
2.
go back to reference Chung, JY, Sackier, JM 1998A method of objectively evaluating improvements in laparoscopic skillsSurg Endosc1211111116CrossRefPubMed Chung, JY, Sackier, JM 1998A method of objectively evaluating improvements in laparoscopic skillsSurg Endosc1211111116CrossRefPubMed
3.
go back to reference Cuschieri, A, Francis, N, Crosby, J, Hanna, GB 2001What do master surgeons think of surgical competence and revalidation?Am J Surg182110116CrossRefPubMed Cuschieri, A, Francis, N, Crosby, J, Hanna, GB 2001What do master surgeons think of surgical competence and revalidation?Am J Surg182110116CrossRefPubMed
4.
go back to reference Deziel, DJ, Millikan, KW, Economou, SG, Doolas, A, Ko, ST, Airan, MC 1993Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 casesAm J Surg165914PubMed Deziel, DJ, Millikan, KW, Economou, SG, Doolas, A, Ko, ST, Airan, MC 1993Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 casesAm J Surg165914PubMed
5.
go back to reference Eubanks, TR, Clements, RH, Pohl, D, Williams, N, Schaad, DC, Horgan, S, et al. 1999An objective scoring system for laparoscopic cholecystectomyJ Am Coll Surg189566574CrossRefPubMed Eubanks, TR, Clements, RH, Pohl, D, Williams, N, Schaad, DC, Horgan, S,  et al. 1999An objective scoring system for laparoscopic cholecystectomyJ Am Coll Surg189566574CrossRefPubMed
6.
go back to reference Fleshman, JW, Fry, RD, Birnbaum, EH, Kodner, IJ 1996Laparoscopic-assisted and minilaparotomy approaches to colorectal diseases are similar in early outcomeDis Colon Rectum391522CrossRefPubMed Fleshman, JW, Fry, RD, Birnbaum, EH, Kodner, IJ 1996Laparoscopic-assisted and minilaparotomy approaches to colorectal diseases are similar in early outcomeDis Colon Rectum391522CrossRefPubMed
7.
go back to reference Gallagher, AG, Satava, RM 2002Virtual reality as a metric for the assessment of laparoscopic psychomotor skills. Learning curves and reliability measuresSurg Endosc1617461752CrossRefPubMed Gallagher, AG, Satava, RM 2002Virtual reality as a metric for the assessment of laparoscopic psychomotor skills. Learning curves and reliability measuresSurg Endosc1617461752CrossRefPubMed
8.
go back to reference Kopta, JA 1971An approach to the evaluation of operative skillsSurgery70297303PubMed Kopta, JA 1971An approach to the evaluation of operative skillsSurgery70297303PubMed
9.
go back to reference Lekawa, M, Shapiro, SJ, Gordon, LA, Rothbart, J, Hiatt, JR 1995The laparoscopic learning curveSurg Laparosc Endosc5455458PubMed Lekawa, M, Shapiro, SJ, Gordon, LA, Rothbart, J, Hiatt, JR 1995The laparoscopic learning curveSurg Laparosc Endosc5455458PubMed
10.
go back to reference Mori, T, Hatano, N, Maruyama, S, Atomi, Y 1998Significance of “hands-on training” in laparoscopic surgerySurg Endosc12256260CrossRefPubMed Mori, T, Hatano, N, Maruyama, S, Atomi, Y 1998Significance of “hands-on training” in laparoscopic surgerySurg Endosc12256260CrossRefPubMed
11.
go back to reference Peters, JH, Ellison, EC, Innes, JT, Liss, JL, Nichols, KE, Lomano, JM, et al. 1991Safety and efficacy of laparoscopic cholecystectomy. A prospective analysis of 100 initial patientsAnn Surg213312PubMed Peters, JH, Ellison, EC, Innes, JT, Liss, JL, Nichols, KE, Lomano, JM,  et al. 1991Safety and efficacy of laparoscopic cholecystectomy. A prospective analysis of 100 initial patientsAnn Surg213312PubMed
12.
go back to reference Regehr, G, MacRae, H, Reznick, RK, Szalay, D 1998Comparing the psychometric properties of checklists and global rating scales for assessing performance on an OSCE-format examinationAcad Med73993997PubMed Regehr, G, MacRae, H, Reznick, RK, Szalay, D 1998Comparing the psychometric properties of checklists and global rating scales for assessing performance on an OSCE-format examinationAcad Med73993997PubMed
13.
go back to reference Reznick, RK 1993Teaching and testing technical skillsAm J Surg165358361PubMed Reznick, RK 1993Teaching and testing technical skillsAm J Surg165358361PubMed
14.
go back to reference Rosser, JC, Rosser, LE, Savalgi, RS 1997Skill acquisition and assessment for laparoscopic surgeryArch Surg132200204PubMed Rosser, JC, Rosser, LE, Savalgi, RS 1997Skill acquisition and assessment for laparoscopic surgeryArch Surg132200204PubMed
15.
go back to reference Rosser, JC,Jr, Rosser, LE, Savalgi, RS 1998Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeonsArch Surg133657661CrossRefPubMed Rosser, JC,Jr, Rosser, LE, Savalgi, RS 1998Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeonsArch Surg133657661CrossRefPubMed
16.
go back to reference Royston, CM, Lansdown, MR, Brough, WA 1994Teaching laparoscopic surgery: the need for guidelinesBr Med J30810231025 Royston, CM, Lansdown, MR, Brough, WA 1994Teaching laparoscopic surgery: the need for guidelinesBr Med J30810231025
17.
go back to reference Simons, AJ, Anthone, GJ, Ortega, AE, Franklin, M, Fleshman, J, Geis, WP, et al. 1995Laparoscopic-assisted colectomy learning curveDis Colon Rectum38600603CrossRefPubMed Simons, AJ, Anthone, GJ, Ortega, AE, Franklin, M, Fleshman, J, Geis, WP,  et al. 1995Laparoscopic-assisted colectomy learning curveDis Colon Rectum38600603CrossRefPubMed
18.
go back to reference Smith, CD, Farrell, TM, McNatt, SS, Metreveli, RE 2001Assessing laparoscopic manipulative skillsAm J Surg181547550CrossRefPubMed Smith, CD, Farrell, TM, McNatt, SS, Metreveli, RE 2001Assessing laparoscopic manipulative skillsAm J Surg181547550CrossRefPubMed
19.
go back to reference Smith, SG, Torkington, J, Brown, TJ, Taffinder, NJ, Darzi, A 2002Motion analysisSurg Endosc16640645CrossRefPubMed Smith, SG, Torkington, J, Brown, TJ, Taffinder, NJ, Darzi, A 2002Motion analysisSurg Endosc16640645CrossRefPubMed
20.
go back to reference Spencer, FC, Spencer, FC 1978Teaching and measuring surgical techniques—the technical evaluation of competenceBull Am Coll Surgeons63912 Spencer, FC, Spencer, FC 1978Teaching and measuring surgical techniques—the technical evaluation of competenceBull Am Coll Surgeons63912
21.
go back to reference Taffinder, N, Smith, S, Mair, J, Russell, R, Darzi, A 1999Can a computer measure surgical precision? Reliability, validity and feasibility of the ICSADSurg Endosc1381 Taffinder, N, Smith, S, Mair, J, Russell, R, Darzi, A 1999Can a computer measure surgical precision? Reliability, validity and feasibility of the ICSADSurg Endosc1381
22.
go back to reference Watts, J, Feldman, WB 1985Assessment of technical skillsNeufeld, VRNorman, GR eds. Assessing clinical competenceSpringerNew York259274 Watts, J, Feldman, WB 1985Assessment of technical skillsNeufeld, VRNorman, GR eds. Assessing clinical competenceSpringerNew York259274
Metadata
Title
Bimodal assessment of laparoscopic suturing skills: Construct and concurrent validity
Authors
K. Moorthy
Y. Munz
A. Dosis
F. Bello
A. Chang
A. Darzi
Publication date
01-11-2004
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 11/2004
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-003-9312-5

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