Determining a Learning Curve for Complex Laparoscopic Gastrointestinal Surgery

描述（由申请人提供）：确定复杂腹腔镜胃肠手术的学习曲线。本项目的目的是验证腹腔镜手术技能全球评估（GOALS）作为评估工具的有效性，并确定复杂腹腔镜胃肠手术的学习曲线。我们将利用奖学金委员会中央数据库中先前记录的数据，分析外科研究员在进行六种不同手术时的表现评分。分析分为三个阶段。由于各种因素影响技术性能，我们将首先将以往经验和案例难度等因素与用goal衡量的性能分数相关联。第二，通过比较研究员在奖学金年度开始和结束时的绩效分数，我们将确定GOALS是否可以区分新研究员和即将毕业的研究员，并建立结构效度。第三，在这个小额资助项目中，我们将通过绘制整个学年期间的表现来定义学习曲线，同时考虑到以前的经验和其他可能影响曲线的因素。该项目的创新之处在于使用国家数据集来确定复杂胃肠（GI）手术的外科医生的学习曲线。这应该为确定技术外科培训的必要组成部分和我们可以实施基于熟练程度的培训的工具提供坚实的证据。

DESCRIPTION (provided by applicant): Determining a Learning Curve for Complex Laparoscopic Gastrointestinal Surgery. The purpose of this project is to validate the Global Operative Assessment of Laparoscopic Skills (GOALS) as an assessment tool and define the learning curve for complex laparoscopic gastrointestinal surgery. Using previously recorded data from a centralized database of the Fellowship Council, we will analyze the performance scores of surgical fellows when performing six different operations. There are three phases of the analysis. Since various factors impact technical performance, we will first correlate factors such as previous experience and case difficulty with performance scores as measured with GOALS. Second, by comparing performance scores of fellows at the beginning of the fellowship year with their scores at the end of the fellowship year, we will determine whether GOALS can differentiate novice fellows from graduating fellows and establish construct validity. Third, we wil define the learning curve in this small grant project by plotting performance over time through the academic year while accounting for previous experience and other factors that might impact the curve. The innovation in this project is the use of a national data set to determine the learning curve for surgical fellows for complex gastrointestinal (GI) operations. This should provide solid evidence on which to define the necessary components of technical surgical training and a tool with which we can implement proficiency-based training.