Research article summary:

Evaluating minimally invasive surgery training using low-cost mechanical simulations.

Abstract Extract:
BACKGROUND: The goal of this study was to develop, test, and validate the efficacy of inexpensive mechanical minimally invasive surgery (MIS) model simulations for training faculty, residents, and medical students. We sought to demonstrate that trained ... (Full abstract text below)

Published 2003Apr in Journal: Surg Endosc (Language : eng)

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1. Surg Endosc. 2003 Apr;17(4):580-5

Evaluating minimally invasive surgery training using low-cost mechanical simulations.

Adrales GL, Chu UB, Witzke DB, Donnelly MB, Hoskins D, Mastrangelo MJ, Gandsas A, Park AE

Center for Minimally Invasive Surgery, University of Kentucky, Lexington, KY 40536-0298, USA.

BACKGROUND: The goal of this study was to develop, test, and validate the efficacy of inexpensive mechanical minimally invasive surgery (MIS) model simulations for training faculty, residents, and medical students. We sought to demonstrate that trained and experienced MIS surgeon raters could reliably rate the MIS skills acquired during these simulations. METHODS: We developed three renewable models that represent difficult or challenging segments of laparoscopic procedures; laparoscopic appendectomy (LA), laparoscopic cholecystectomy (LC), and laparoscopic inguinal hernia (LH). We videotaped 10 students, 12 surgical residents, and 1 surgeon receiving training on each of the models and again during their posttraining evaluation session. Five MIS surgeons then assessed the evaluation session performance. For each simulation, we asked them to rate overall competence (COM) and four skills: clinical judgment (respect for tissue) (CJ), dexterity (economy of movement) (DEX), serial/simultaneous complexity (SSC), and spatial orientation (SO). We computed intraclass correlation (ICC) coefficients to determine the extent of agreement (i.e., reliability) among ratings. RESULTS: We obtained ICC values of 0.74, 0.84, and 0.81 for COM ratings on LH, LC, and LA, respectively. We also obtained the following ICC values for the same three models: CJ, 0.75, 0.83, and 0.89; DEX, 0.88, 0.86, and 0.89; SSC, 0.82, 0.82, and 0.82; and SO, 0.86, 0.86, and 0.87, respectively. CONCLUSIONS: We obtained very high reliability of performance ratings for competence and surgical skills using a mechanical simulator. Typically, faculty evaluations of residents in the operating room are much less reliable. In contrast, when faculty members observe residents in a controlled, standardized environment, their ratings can be very reliable.

PMID : 12582771 [PubMed - Indexed for MEDLINE]

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Full Author Information

First Name	LastName	Initials
G L	Adrales	GL
U B	Chu	UB
D B	Witzke	DB
M B	Donnelly	MB
D	Hoskins	D
M J	Mastrangelo	MJ
A	Gandsas	A
A E	Park	AE

Affiliation: Center for Minimally Invasive Surgery, University of Kentucky, Lexington, KY 40536-0298, USA.

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