Global Evaluative Assessment of Robotic Skills: Validation of a Clinical Assessment Tool to Measure Robotic Surgical Skills
Global Evaluative Assessment of Robotic Skills: Validation of a Clinical Assessment Tool to Measure Robotic Surgical Skills
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DOI：
10.1016/j.juro.2011.09.032
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发表时间：
2012-01-01
影响因子：
6.6
通讯作者：
Dunkin, Brian J.
中科院分区：
文献类型：
--
作者：
Goh, Alvin C.;Goldfarb, David W.;Dunkin, Brian J.
目的：我们开发并验证了机器人手术技能的标准化评估工具，并报告其实用性，可靠性和结构效度在临床setting.Materials和方法：全球评估评估机器人技能是一种工具，通过解构机器人外科手术的基本要素与专家机器人外科医生协商。在机器人辅助腹腔镜直肠癌切除术期间，采用5分锚定Likert量表在6个领域评估手术性能。通过对每个领域的评级进行求和得出总体绩效评分。专家外科医生和研究生4至6泌尿外科住院医师进行了评估，以确定结构效度。评估完成了由主治外科医生，训练有素的观察员和operator.Results：25名学员和4名主治外科医生共29个评价完成。专家在评估中的得分显著高于新手操作员（p = 0.004）。研究生四年级和五年级住院医师的得分显著低于专家组（p < 0.05），而研究生六年级实习生和主治外科医生的平均绩效得分之间没有差异（p > 0.05）。内部一致性的评估工具是优秀的（克朗巴赫的α = 0.90至0.93）。整体评估评分ICC评分为0.80（95%CI 0.65-0.90）。结论：机器人技能的全球评价评估管理简单，能够区分机器人手术专业知识的水平。这一标准化评估工具具有良好的一致性、可靠性和有效性。进一步的研究是必要的，以评估其有用的外科教育和建立能力的机器人手术。
Purpose: We developed and validated a standardized assessment tool for robotic surgical skills, and report its usefulness, reliability and construct validity in a clinical setting.Materials and Methods: The Global Evaluative Assessment of Robotic Skills is a tool developed by deconstructing the fundamental elements of robotic surgical procedures in consultation with expert robotic surgeons. Surgical performance was assessed during robot-assisted laparoscopic prostatectomy on a 5-point anchored Likert scale across 6 domains. An overall performance score was derived by summing the ratings in each domain. Expert surgeons and postgraduate year 4 to 6 urology residents were evaluated to determine construct validity. Assessments were completed by the attending surgeon, a trained observer and the operator.Results: A total of 29 evaluations of 25 trainees and 4 attending surgeons were completed. Experts scored significantly higher on the assessment than novice operators (p = 0.004). Postgraduate year 4 and 5 residents scored significantly lower than the expert group (p < 0.05) while no difference was observed between mean performance scores of postgraduate year 6 trainees and attending surgeons (p > 0.05). The internal consistency of the assessment tool was excellent (Cronbach's alpha = 0.90 to 0.93). The overall assessment score ICC among raters was 0.80 (95% CI 0.65-0.90).Conclusions: The Global Evaluative Assessment of Robotic Skills is simple to administer and able to differentiate levels of robotic surgical expertise. This standardized assessment tool shows excellent consistency, reliability and validity. Further study is warranted to evaluate its usefulness for surgical education and the establishment of competency in robotic surgery.