Anastomosis Lapse Index (ALI): A Validated End Product Assessment Tool for Simulation Microsurgery Training.
J Reconstr Microsurg
; 32(3): 233-41, 2016 Mar.
Article
em En
| MEDLINE
| ID: mdl-26645156
ABSTRACT
BACKGROUND:
Over the last decade, simulation has become a principal training method in microsurgery. With an increasing move toward the use of nonliving models, there is a need to develop methods for assessment of microvascular anastomosis skill acquisition substituting traditional patency rate. The authors present and validate a novel method of microvascular anastomosis assessment tool for formative and summative skills competency assessment.METHODS:
In this study, 29 trainees with varying levels of experience in microsurgery undertook a 5-day microsurgery course. Two consecutive end-to-end microvascular anastomoses of cryopreserved rat aortas performed on day 3 and day 5 of the course were longitudinally split and photographed for randomized blinded qualitative evaluation. Four consecutive anastomoses by two experienced microsurgeons were analyzed as expert controls. Errors potentially leading to anastomotic leak or thrombosis were identified and logged. Statistical analysis using the Kruskal-Wallis analysis of variance (ANOVA) and a two-way repeated measure ANOVA was used to measure construct and concurrent validity, respectively.RESULTS:
A total of 128 microvascular anastomoses were analyzed for both student and control groups. Ten errors were identified and indexed. There was a statistically significant difference detected between average errors per anastomosis performed between groups (p < 0.05). Average errors per anastomosis was statistically decreased on day 5 of the course compared with day 3 (p < 0.001).CONCLUSION:
Evaluation of anastomosis structural patency and quality in nonliving models is possible. The proposed error list showed construct and predictive validity. The anastomosis lapse index can serve as a formative and summative assessment tool during microvascular training.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Anastomose Cirúrgica
/
Competência Clínica
/
Treinamento por Simulação
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Microcirurgia
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
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Qualitative_research
Limite:
Animals
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article