A global assessment tool for evaluation of intraoperative laparoscopic skills
A global assessment tool for evaluation of intraoperative laparoscopic skills
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DOI：
10.1016/j.amjsurg.2005.04.004
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发表时间：
2005-07-01
影响因子：
3
通讯作者：
Fried, GM
中科院分区：
文献类型：
--
作者：
Vassiliou, MC;Feldman, LS;Fried, GM
背景资料：有一个迫切需要的术中评估工具，满足高标准的可靠性和有效性，作为不同的训练策略的结果措施。本研究的目的是开发一种工具，具体的腹腔镜技能，并评估其可靠性和validation.Methods：全球手术评估腹腔镜技能（GOALS）包括一个5项全球评级量表。还使用了10项检查表和2个视觉模拟量表（VAS）评估能力和病例难度。在腹腔镜胆囊切除术期间，21名参与者由主治外科医生、2名经过培训的观察员和自我评估进行评估，同时从肝床解剖胆囊。GOALS总分的组内相关系数（ICC）为0.89（95%置信区间[CI] .74至.95），观察者与主治外科医生之间为.82（95% CI .67至.92），参与者与主治外科医生之间为.70（95% CI .37至.87）。VAS（能力）和自评量表的ICC（观察员）分别为0.69和0.70。新手（研究生年限[PGY] 1 - 3）的平均GOALS总分（观察员）为13（95%CI 10.3 - 15.7），而经验丰富者（PGY 4-主治外科医生，P = 0.0006）为19.4（95%CI 17.2 - 21.5）。VAS表现出新手和有经验的参与者之间的得分差异（P =.001），但是，任务清单没有（P =.09）。结论：这些数据表明，目标是可行的，可靠的，有效的。他们还认为，对于有经验的评分者的技术技能评价，它上级任务清单和VAS。研究结果支持使用目标在腹腔镜技能的培训和评估。(c)2005 Excerpta Medica Inc. All rights reserved.
Background: There is a pressing need for an intraoperative assessment tool that meets high standards of reliability and validity to use as an outcome measure for different training strategies. The aim of this study was to develop a tool specific for laparoscopic skills and to evaluate its reliability and validity.Methods: The Global Operative Assessment of Laparoscopic Skills (GOALS) consists of a 5-item global rating scale. A 10-item checklist and 2 visual analogue scales (VAS) for competence and case difficulty were also used. During laparoscopic cholecystectomy, 21 participants were evaluated by the attending surgeon, by 2 trained observers and by self-assessment while dissecting the gallbladder from the liver bed.Results: The intraclass correlation coefficient (ICC) for the total GOALS score was .89 (95% confidence interval [CI] .74 to .95) between observers, .82 (95% CI .67 to .92) between observers and attending surgeons, and .70 (95% CI .37 to .87) between participants and attending surgeons. The ICCs (observers) for the VAS (competence) and the checklist were .69 and .70, respectively. The mean total GOALS score (observers) for novices (postgraduate years [PGYs] 1 through 3) was 13 (95% CI 10.3 to 15.7) compared with 19.4 (95% Cl 17.2 to 21.5) for experienced (PGY 4 through attending surgeons, P =.0006). The VAS demonstrated a difference in scores between novice and experienced participants (P =.001); however, the task checklist did not (P =.09).Conclusions: These data indicate that GOALS is feasible, reliable, and valid. They also suggest that it is superior to the task checklist and VAS for evaluation of technical skill by experienced raters. The findings support the use of GOALS in the training and evaluation of laparoscopic skills. (c) 2005 Excerpta Medica Inc. All rights reserved.