Fransson Boel A, Ragle Claude A, Bryan Margaret E
Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA 99164-6610, USA.
J Vet Med Educ. 2010 Fall;37(3):304-13. doi: 10.3138/jvme.37.3.304.
Our aim in this study was to validate a test of laparoscopic surgical performance by determining the relation of scores from an objective structured assessment of technical skills performed in a canine abdominal model to experience and basic laparoscopic skills. The number of years the participants had performed rigid video-endoscopic procedures (VEP), using triangulation skills, correlated positively with both evaluators' total surgical performance scores for all three evaluation methods: global rating scale, visual analog scale (VAS) rating of overall performance, and operative component rating scale (OCRS). Experience of VEP without triangulation skills (i.e., flexible endoscopy, otoscopy) or video game experience did not correlate with surgical performance. A highly validated basic laparoscopic skills assessment (McGill University inanimate system for training and evaluation of laparoscopic skills, or MISTELS) score was strongly correlated with the VAS score for surgical performance and OCRS scores. Inter-rater reliability was high for the VAS and OCRS evaluation methods, and scores from the detailed OCRS method did not differ between evaluators. In conclusion, the surgical performance test correlated with VEP triangulation experience and basic laparoscopic skills. This type of test needs to be evaluated in a larger sample population including higher numbers of veterinary laparoscopic surgeons for further validation.
我们这项研究的目的是通过确定在犬腹部模型中进行的客观结构化技术技能评估得分与经验及基本腹腔镜技能之间的关系，来验证一项腹腔镜手术操作测试。参与者使用三角测量技能进行硬质视频内镜手术（VEP）的年限，与所有三种评估方法（整体评分量表、整体表现视觉模拟量表[VAS]评分以及手术组成部分评分量表[OCRS]）的评估者总手术操作得分均呈正相关。不具备三角测量技能的VEP经验（即软性内镜检查、耳镜检查）或电子游戏经验与手术操作表现无关。一项经过高度验证的基本腹腔镜技能评估（麦吉尔大学腹腔镜技能训练与评估无生命系统，或MISTELS）得分与手术操作表现的VAS评分及OCRS评分密切相关。VAS和OCRS评估方法的评估者间信度较高，详细的OCRS方法所得分数在评估者之间并无差异。总之，手术操作测试与VEP三角测量经验及基本腹腔镜技能相关。需要在更大样本群体（包括更多数量的兽医腹腔镜外科医生）中对这类测试进行评估，以作进一步验证。
