Abstract
Background
acquiring technical expertise for neonatal thoracoscopy is challenging. To address
this, we designed a fully synthetic thoracoscopic simulator for which we established
its construct validity.
Methods
three thoracoscopic tasks were assessed: ring transfer, needle pass and incision of
a blind upper esophageal pouch (EA cut). Participants watched instructional videos
with accompanying written instructions for each task before having their attempt video
recorded. All tasks were marked by three blinded pediatric surgeons using a modified
Objective Structured Assessment of Technical Skills (OSATS). Scores were assessed
using appropriate statistical analysis and inter-rater reliability was analyzed by
interclass correlation coefficient (ICC).
Results
23 participants completed the ring transfer and needle pass and 21 the EA cut: 5 experts
(consultant surgeons), 5 intermediate (registrars on a training program) and 13 novices
(medical students, house surgeons or non-training registrars). All three tasks distinguished
between novice and intermediate/expert (ring transfer p = 0.00001, needle pass p = 0.0004 and EA cut p = 0.0014, respectively). Interrater reliability was good for ring transfer and needle
pass but poor for EA cut.
Conclusion
the tasks distinguished between novice and intermediate/expert but not between expert
and intermediate. In needle pass and EA cut, there was a trend for the experts to
score higher than intermediate participants. Ring transfer and needle pass tasks achieved
construct validity, had good interrater reliability and were found to be useful in
assessing a novice surgeon's progression towards the intermediate level. Distinguishing
between intermediate and expert may require assessment of more complex tasks such
as intracorporeal suturing and tying.
Level of evidence
II
Keywords
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Article info
Publication history
Published online: April 04, 2021
Accepted:
March 26,
2021
Received in revised form:
March 21,
2021
Received:
October 14,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
