Surgery Tutor for Computational Assessment of Technical Proficiency in Soft-Tissue Tumor Resection in a Simulated Setting.
J Surg Educ
; 76(3): 872-880, 2019.
Article
en En
| MEDLINE
| ID: mdl-30567671
ABSTRACT
BACKGROUND:
In competency-based medical education, progression between milestones requires reliable and valid methods of assessment. Surgery Tutor is an open-source motion tracking platform developed to objectively assess technical proficiency during open soft-tissue tumor resections in a simulated setting. The objective of our study was to provide evidence in support of construct validity of the scores obtained by Surgery Tutor. We hypothesized that Surgery Tutor would discriminate between novice, intermediate, and experienced operators.METHODS:
Thirty participants were assigned to novice, intermediate, or experienced groups, based on the number of prior soft-tissue resections performed. Each participant resected 2 palpable and 2 nonpalpable lesions from a soft-tissue phantom. Surgery Tutor was used to track hand and instrument motions, number of tumor breaches, and time to perform each resection. Mass of excised specimens and margin status were also recorded.RESULTS:
Surgery Tutor scores demonstrated "moderate" to "good" internal structure (test-retest reliability) for novice, intermediate, and experienced groups (interclass correlation coefficientâ¯=â¯0.596, 0.569, 0.737; p < 0.001). Evidence in support of construct validity (consequences) was demonstrated by comparing scores of novice, intermediate, and experienced participantsfor number of hand and instrument motions (690 ± 190, 597 ± 169, 469 ± 110; p < 0.001), number of tumor breaches (29 ± 34, 16 ± 11, 9 ± 6; p < 0.001), time per resection (677 ± 331 seconds, 561 ± 210 seconds, 449 ± 148 seconds; p < 0.001), mass of completely excised specimens (22 ± 7g, 21 ± 11g, 17 ± 6 g; pâ¯=â¯0.035), and rate of positive margin (68%, 50%, 28%; p < 0.001). There was "strong" and "moderate" relationships between motion scores and Objective Structured Assessment of Technical Skill scores, and time per resection and Objective Structured Assessment of Technical Skill scores respectively (râ¯=â¯-0.60, p < 0.001; râ¯=â¯-0.54, p < 0.001).CONCLUSION:
Surgery Tutor scores demonstrate evidenceof construct validity with regards to good internal structure, consequences, and relationship to other variables in the assessment of technical proficiency duringopen soft-tissue tumor resections in a simulated setting. Utilization of Surgery Tutor can provide formative feedback and objective assessment of surgical proficiency in a simulated setting.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Competencia Clínica
/
Educación de Postgrado en Medicina
/
Evaluación Educacional
/
Entrenamiento Simulado
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Surg Educ
Año:
2019
Tipo del documento:
Article