Development and validation of a procedure-specific assessment tool for hands-on surgical training in congenital heart surgery
Development and validation of a procedure-specific assessment tool for hands-on surgical training in congenital heart surgery
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DOI：
10.1016/j.jtcvs.2019.11.130
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发表时间：
2020-07-01
影响因子：
6
通讯作者：
Yoo, Shi-Joon
中科院分区：
文献类型：
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作者：
Hussein, Nabil;Lim, Andrew;Yoo, Shi-Joon
背景：实践手术模拟一直致力于解决先天性心脏病手术 (CHS) 中的培训限制。然而，需要客观的评估方法来衡量外科医生的表现，以证明其全球采用的合理性。本研究旨在验证用于在 3D 打印模型上模拟动脉调换手术的特定手术评估工具，并评估具有不同 CHS 经验水平的评估者之间评分的一致性。方法：5 名“专家”和 5 名“初级”外科医生在 2 场实践手术培训课程中，在 3D 打印模型上进行了大动脉转位的动脉调换手术。他们的表现由 9 名具有不同 CHS 经验的评估者（外科医生、住院医师和非 MD 评估者）进行回顾性评估。使用 2 种评估工具进行评估：先天性心脏病手术实践培训 (HOST-CHS) 评估工具和全球评级量表 (GRS)。结果：与 GRS 相比，HOST-CHS 工具显示出更高的评估者间和评估者内可靠性。所有评估者的专家外科医生的总分高度一致。非医学博士评估者对初级外科医生的总分略高于住院医师和工作人员评估者。所有级别的评估者都能够区分初级外科医生和专家外科医生。结论：本研究证明了针对动脉调转手术的客观、针对具体手术的评估工具的开发和验证，并且具有不同经验的评估者之间的一致性。现在有了一个量化和准确评估绩效的平台，这对于培养和培养下一代先天性心脏病外科医生将非常有益。
Background: Hands-on surgical simulation has been sought to address training limitations within congenital heart surgery (CHS). However, there is a need for objective assessment methods to measure surgeons' performance to justify its global adoption. This study aimed to validate a procedure-specific assessment tool for the simulation of the arterial switch operation on 3D-printed models and to evaluate the consistency of scoring among evaluators with different levels of experience in CHS.Methods: Five "expert" and 5 "junior" surgeons performed the arterial switch procedure on 3D-printed models with transposition of the great arteries during 2 hands-on surgical training courses. Their performance was retrospectively assessed by 9 evaluators with varying experience in CHS (staff surgeons, resident surgeons, and non-MD raters). Assessments were done using 2 assessment tools: the Hands-On Surgical Training-Congenital Heart Surgery (HOST-CHS) assessment tool and the global rating scale (GRS).Results: The HOST-CHS tool showed a higher interrater and intrarater reliability compared with the GRS. Total scores for expert surgeons were highly consistent across all evaluators. Non-MD raters' total scores for junior surgeons were slightly higher than those of residents and staff evaluators. All grades of evaluator were able to discriminate between junior and expert surgeons.Conclusions: This study demonstrates the development and validation of an objective, procedure-specific assessment tool for the arterial switch operation with consistency among evaluators with different experience. There is now a platform for quantifying and accurately evaluating performance, which will be highly beneficial in training and developing the next generation of congenital heart surgeons.