Chang Lily, Hogle Nancy J, Moore Brianna B, Graham Mark J, Sinanan Mika N, Bailey Robert, Fowler Dennis L
Boston University Medical Center, Department of Surgery, Boston, Massachusetts, USA.
Surg Innov. 2007 Jun;14(2):122-6. doi: 10.1177/1553350607301742.
The Global Operative Assessment of Laparoscopic Skills (GOALS) is a valid assessment tool for objectively evaluating the technical performance of laparoscopic skills in surgery residents. We hypothesized that GOALS would reliably differentiate between an experienced (expert) and an inexperienced (novice) laparoscopic surgeon (construct validity) based on a blinded videotape review of a laparoscopic cholecystectomy procedure. Ten board-certified surgeons actively engaged in the practice and teaching of laparoscopy reviewed and evaluated the videotaped operative performance of one novice and one expert laparoscopic surgeon using GOALS. Each reviewer recorded a score for both the expert and the novice videotape reviews in each of the 5 domains in GOALS (depth perception, bimanual dexterity, efficiency, tissue handling, and overall competence). The scores for the expert and the novice were compared and statistically analyzed using single-factor analysis of variance (ANOVA). The expert scored significantly higher than the novice did in the domains of depth perception (p = .005), bimanual dexterity (p = .001), efficiency (p = .001), and overall competence ( p = .001). Interrater reliability for the reviewers of the novice tape was Cronbach alpha = .93 and the expert tape was Cronbach alpha = .87. There was no difference between the two for tissue handling. The Global Operative Assessment of Laparoscopic Skills is a valid, objective assessment tool for evaluating technical surgical performance when used to blindly evaluate an intraoperative videotape recording of a laparoscopic procedure.
全球腹腔镜手术技能操作评估（GOALS）是一种有效的评估工具，用于客观评估外科住院医师腹腔镜手术技能的技术表现。我们假设，基于对腹腔镜胆囊切除术过程的盲态录像回顾，GOALS能够可靠地区分经验丰富（专家级）和经验不足（新手级）的腹腔镜外科医生（结构效度）。十位积极从事腹腔镜手术实践与教学的委员会认证外科医生，使用GOALS对一名新手和一名专家级腹腔镜外科医生的录像手术表现进行了回顾和评估。每位评审员在GOALS的5个领域（深度感知、双手灵巧性、效率、组织处理和总体能力）中，分别为专家和新手的录像回顾记录了一个分数。对专家和新手的分数进行比较，并使用单因素方差分析（ANOVA）进行统计分析。在深度感知（p = .005）、双手灵巧性（p = .001）、效率（p = .001）和总体能力（p = .001）领域，专家的得分显著高于新手。新手录像评审员的评分者间信度为Cronbach α = .93，专家录像的评分者间信度为Cronbach α = .87。在组织处理方面，两者之间没有差异。当用于盲目评估腹腔镜手术的术中录像记录时，全球腹腔镜手术技能操作评估是一种评估手术技术表现的有效、客观的评估工具。
