Evaluating competency in video-assisted thoracoscopic surgery (VATS) lobectomy performance using a novel assessment tool and virtual reality simulation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-09-17

AUTHORS

Katrine Jensen, Henrik Jessen Hansen, René Horsleben Petersen, Kirsten Neckelmann, Henrik Vad, Lars Borgbjerg Møller, Jesper Holst Pedersen, Lars Konge

ABSTRACT

BackgroundCompetency-based training has gained ground in surgical training and with it assessment tools to ensure that training objectives are met. Very few assessment tools are available for evaluating performance in thoracoscopic procedures. Video recordings would provide the possibility of blinded assessment and limited rater bias. This study aimed to provide validity evidence for a newly developed and dedicated tool for assessing competency in Video-Assisted Thoracoscopic Surgery (VATS) lobectomy.MethodsParticipants with varying experience with VATS lobectomy were included from different countries. Video recordings from participants’ performance of a VATS right upper lobe lobectomy on a virtual reality simulator were rated by three raters using a modified version of a newly developed VATS lobectomy assessment tool (the VATSAT) and analyzed in relation to the unitary framework (content, response process, internal structure, relation to other variables, and consequences of testing).ResultsFifty-three participants performed two consecutive simulated VATS lobectomies on the virtual reality simulator, leaving a total of 106 videos. Content established in previously published studies. Response process Standardized data collection was ensured by using an instructional element, uniform data collection, a special rating program, and automatic generation of the results to a database. Raters were carefully instructed in using the VATSAT, and tryout ratings were carried out. Internal structure Inter-rater reliability was calculated as intra-class correlation coefficients, to 0.91 for average measures (p < 0.001). Test/re-test reliability was calculated as Pearson’s r of 0.70 (p < 0.001). G-coefficient was calculated to be 0.79 with two procedures and three raters. By performing D-theory was found that either three procedures rated by two raters or five procedures rated by one rater were enough to reach an acceptable G-coefficient of ≥ 0.8. Relation to other variables Significant differences between groups were found (p < 0.001). The participants’ VATS lobectomy experience correlated significantly to their VATSAT score (p = 0.016). Consequences of testing The pass/fail score was found to be 14.9 points by the contrasting groups’ method, leaving five false positive (29%) and six false negatives (43%).ConclusionValidity evidence was provided for the VATSAT according to the unitary framework. The VATSAT provides supervisors and assessors with a procedure-specific assessment tool for evaluating VATS lobectomy performance and aids with the decision of when the trainee is ready for unsupervised performance. More... »

PAGES

1465-1473

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-018-6428-1

DOI

http://dx.doi.org/10.1007/s00464-018-6428-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1107055038

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30225606


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65 false negatives
66 framework
67 generation
68 ground
69 group
70 instructional elements
71 inter-rater reliability
72 intra-class correlation coefficient
73 lobectomy
74 measures
75 method
76 negatives
77 novel assessment tool
78 objective
79 participants
80 pass/fail score
81 performance
82 point
83 possibility
84 procedure
85 procedure-specific assessment tool
86 program
87 rater bias
88 raters
89 rating program
90 ratings
91 re-test reliability
92 reality simulation
93 reality simulator
94 recordings
95 relation
96 reliability
97 results
98 right upper lobe lobectomy
99 scores
100 significant differences
101 simulations
102 simulator
103 standardized data collection
104 study
105 supervisors
106 surgical training
107 test/re-test reliability
108 thoracoscopic procedures
109 thoracoscopic surgery lobectomy
110 tool
111 total
112 trainees
113 training
114 training objectives
115 uniform data collection
116 unitary framework
117 unsupervised performance
118 upper lobe lobectomy
119 validity evidence
120 variables significant differences
121 version
122 video
123 video recordings
124 virtual reality simulation
125 virtual reality simulator
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