Implementation and validation of a competency assessment tool for laparoscopic cholecystectomy,Surgical Endoscopy

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Implementation and validation of a competency assessment tool for laparoscopic cholecystectomy
Surgical Endoscopy ( IF 2.4 ) Pub Date : 2022-06-15 , DOI: 10.1007/s00464-022-09264-0
Mickael Chevallay ₁ , Emilie Liot ₁ , Ian Fournier ₁ , Ziad Abbassi ₁ , Andrea Peloso ₁ , Monika E Hagen ₁ , Stefan P Mönig ₁ , Philippe Morel ₁ , Christian Toso ₁ , Nicolas Buchs ₁ , Danilo Miskovic ₂ , Frederic Ris ₁ , Minoa K Jung ₁

Affiliation

Background

Achieving proficiency in a surgical procedure is a milestone in the career of a trainee. We introduced a competency assessment tool for laparoscopic cholecystectomy in our residency program. Our aim was to assess the inter-rater reliability of this tool.

Methods

We included all laparoscopic cholecystectomies performed by residents under the supervision of board certified surgeons. All residents were assessed at the end of the procedure by the supervising surgeon (live reviewer) using our competency assessment tool. Video records of the same procedure were analyzed by two independent reviewers (reviewer A and B), who were blinded to the performing trainee’s. The assessment had three parts: a laparoscopic cholecystectomy-specific assessment tool (LCAT), the objective structured assessment of technical skills (OSATS) and a 5-item visual analogue scale (VAS) to address the surgeon’s autonomy in each part of the cholecystectomy. We compared the assessment scores of the live supervising surgeon and the video reviewers.

Results

We included 15 junior residents who performed 42 laparoscopic cholecystectomies. Scoring results from live and video reviewer were comparable except for the OSATS and VAS part. The score for OSATS by the live reviewer and reviewer B were 3.68 vs. 4.26 respectively (p = 0.04) and for VAS (5.17 vs. 4.63 respectively (p = 0.03). The same difference was found between reviewers A and B with OSATS score (3.75 vs. 4.26 respectively (p = 0.001)) and VAS (5.56 vs. 4.63 respectively; p = 0.004)).

Conclusion

Our competency assessment tool for the evaluation of surgical skills specific to laparoscopic cholecystectomy has been shown to be objective and comparable in-between raters during live procedure or on video material.

中文翻译：

腹腔镜胆囊切除术能力评估工具的实施和验证

背景

熟练掌握外科手术是实习生职业生涯中的一个里程碑。我们在住院医师计划中引入了腹腔镜胆囊切除术的能力评估工具。我们的目的是评估该工具的评估者间可靠性。

方法

我们纳入了所有由住院医生在委员会认证外科医生的监督下进行的腹腔镜胆囊切除术。手术结束时，监督外科医生（现场审核员）使用我们的能力评估工具对所有住院医师进行了评估。同一程序的视频记录由两名独立评审员（评审员 A 和 B）进行分析，他们对表演学员的视频不知情。评估分为三个部分：腹腔镜胆囊切除术专用评估工具（LCAT）、技术技能客观结构化评估（OSATS）和5项视觉模拟量表（VAS），以解决外科医生在胆囊切除术每个部分的自主权。我们比较了现场指导外科医生和视频评审员的评估分数。

结果

我们纳入了 15 名初级住院医师，他们进行了 42 例腹腔镜胆囊切除术。除 OSATS 和 VAS 部分外，现场评审员和视频评审员的评分结果具有可比性。现场评审员和评审员 B 的 OSATS 得分分别为 3.68 与 4.26 ( p = 0.04)，VAS 得分分别为 5.17 与 4.63 ( p = 0.03)。评审员 A 和 B 的 OSATS 得分也存在同样的差异（分别为 3.75 与 4.26（p = 0.001））和 VAS（分别为 5.56 与 4.63；p = 0.004））。