Adaptation of the fundamentals of laparoscopic surgery box for endoscopic simulation: performance evaluation of the first 100 participants.


Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
10 2019
Historique:
received: 21 04 2018
accepted: 03 12 2018
pubmed: 4 1 2019
medline: 19 5 2020
entrez: 4 1 2019
Statut: ppublish

Résumé

The paucity of readily accessible, cost-effective models for the simulation, practice, and evaluation of endoscopic skills present an ongoing barrier for resident training. We have previously described a system for conversion of the Fundamentals of Laparoscopic Surgery box (FLS) for flexible endoscopic simulation. Six endoscopic tasks focusing on scope manipulation, and other clinically relevant endoscopic skills are performed within a 5-min time limit per task. This study describes our experience and validation results with the first 100 participants. A total of 100 participants were evaluated on the simulator. Thirty individuals were classified as experts (having done over 200 endoscopic procedures), and 70 were classified as trainees (39 individuals reported having no prior endoscopy experience). Of the 100 participants, 55 individuals were retested on the simulator within a period of 4 months. These 55 individuals were also evaluated using the "Global Assessment of Gastrointestinal Endoscopic Skills" (GAGES). T-tests and Pearson correlations were used where appropriate, values less than 0.05 were considered significant. Experts completed all six tasks significantly faster than trainees. For the 55 participants who were retested on the simulator, all tasks demonstrated evidence of test-retest reliability for both experts and trainees who did not practice in between tests. Moderate correlations between lower completion times and higher GAGES scores were observed for all tasks except the clipping task. The results from the first 100 participants provide evidence for the simulator's validity. Based on task completion times, we found that experts perform significantly better than trainees. Additionally, preliminary data demonstrate evidence of test-retest reliability, as well as GAGES score correlation. Additional studies to determine and validate a scoring system for this simulator are ongoing.

Sections du résumé

BACKGROUND
The paucity of readily accessible, cost-effective models for the simulation, practice, and evaluation of endoscopic skills present an ongoing barrier for resident training. We have previously described a system for conversion of the Fundamentals of Laparoscopic Surgery box (FLS) for flexible endoscopic simulation. Six endoscopic tasks focusing on scope manipulation, and other clinically relevant endoscopic skills are performed within a 5-min time limit per task. This study describes our experience and validation results with the first 100 participants.
METHODS
A total of 100 participants were evaluated on the simulator. Thirty individuals were classified as experts (having done over 200 endoscopic procedures), and 70 were classified as trainees (39 individuals reported having no prior endoscopy experience). Of the 100 participants, 55 individuals were retested on the simulator within a period of 4 months. These 55 individuals were also evaluated using the "Global Assessment of Gastrointestinal Endoscopic Skills" (GAGES). T-tests and Pearson correlations were used where appropriate, values less than 0.05 were considered significant.
RESULTS
Experts completed all six tasks significantly faster than trainees. For the 55 participants who were retested on the simulator, all tasks demonstrated evidence of test-retest reliability for both experts and trainees who did not practice in between tests. Moderate correlations between lower completion times and higher GAGES scores were observed for all tasks except the clipping task.
CONCLUSIONS
The results from the first 100 participants provide evidence for the simulator's validity. Based on task completion times, we found that experts perform significantly better than trainees. Additionally, preliminary data demonstrate evidence of test-retest reliability, as well as GAGES score correlation. Additional studies to determine and validate a scoring system for this simulator are ongoing.

Identifiants

pubmed: 30604259
doi: 10.1007/s00464-018-06617-6
pii: 10.1007/s00464-018-06617-6
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

3444-3450

Références

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Auteurs

Ilay Habaz (I)

Division of General Surgery, University Health Network, University of Toronto, Toronto, Canada.

Silvana Perretta (S)

Institute for Image Guided Surgery IHU-Strasbourg, Strasbourg, France.

Allan Okrainec (A)

Division of General Surgery, University Health Network, University of Toronto, Toronto, Canada.

Oscar M Crespin (OM)

Division of General Surgery, University Health Network, University of Toronto, Toronto, Canada.

Andrea V Kwong (AV)

Division of General Surgery, University Health Network, University of Toronto, Toronto, Canada.

Ethan Weiss (E)

Division of General Surgery, University Health Network, University of Toronto, Toronto, Canada.

Else van der Velden (E)

Institute for Image Guided Surgery IHU-Strasbourg, Strasbourg, France.

Ludovica Guerriero (L)

Institute for Image Guided Surgery IHU-Strasbourg, Strasbourg, France.

Fabio Longo (F)

Institute for Image Guided Surgery IHU-Strasbourg, Strasbourg, France.

Pietro Mascagni (P)

Institute for Image Guided Surgery IHU-Strasbourg, Strasbourg, France.

Louis W C Liu (LWC)

Division of Gastroenterology, University Health Network, Toronto, ON, Canada.

Timothy D Jackson (TD)

Division of General Surgery, University Health Network, University of Toronto, Toronto, Canada.

Lee L Swanstrom (LL)

Institute for Image Guided Surgery IHU-Strasbourg, Strasbourg, France.
Division of GI/MIS, The Oregon Clinic, Portland, OR, USA.

Eran Shlomovitz (E)

Division of General Surgery, University Health Network, University of Toronto, Toronto, Canada. Eran.Shlomovitz@uhn.ca.
Institute for Image Guided Surgery IHU-Strasbourg, Strasbourg, France. Eran.Shlomovitz@uhn.ca.
Division of Interventional Radiology, University Health Network, University of Toronto, Toronto, Canada. Eran.Shlomovitz@uhn.ca.

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