Scott Department of Urology, Baylor College of Medicine, Houston, Texas, USA.
J Urol. 2012 Jan;187(1):247-52. doi: 10.1016/j.juro.2011.09.032. Epub 2011 Nov 17.
We developed and validated a standardized assessment tool for robotic surgical skills, and report its usefulness, reliability and construct validity in a clinical setting.
The Global Evaluative Assessment of Robotic Skills is a tool developed by deconstructing the fundamental elements of robotic surgical procedures in consultation with expert robotic surgeons. Surgical performance was assessed during robot-assisted laparoscopic prostatectomy on a 5-point anchored Likert scale across 6 domains. An overall performance score was derived by summing the ratings in each domain. Expert surgeons and postgraduate year 4 to 6 urology residents were evaluated to determine construct validity. Assessments were completed by the attending surgeon, a trained observer and the operator.
A total of 29 evaluations of 25 trainees and 4 attending surgeons were completed. Experts scored significantly higher on the assessment than novice operators (p = 0.004). Postgraduate year 4 and 5 residents scored significantly lower than the expert group (p <0.05) while no difference was observed between mean performance scores of postgraduate year 6 trainees and attending surgeons (p >0.05). The internal consistency of the assessment tool was excellent (Cronbach's α = 0.90 to 0.93). The overall assessment score ICC among raters was 0.80 (95% CI 0.65-0.90).
The Global Evaluative Assessment of Robotic Skills is simple to administer and able to differentiate levels of robotic surgical expertise. This standardized assessment tool shows excellent consistency, reliability and validity. Further study is warranted to evaluate its usefulness for surgical education and the establishment of competency in robotic surgery.
我们开发并验证了一种用于机器人手术技能的标准化评估工具，并报告其在临床环境中的实用性、可靠性和结构有效性。
全球机器人手术技能评估工具是通过与机器人外科专家协商，对机器人手术程序的基本要素进行解构而开发的。在机器人辅助腹腔镜前列腺切除术期间，使用 5 点锚定李克特量表对 6 个领域的手术表现进行评估。通过对每个领域的评分进行求和来得出总体绩效评分。评估专家外科医生和第 4 至 6 年住院医师以确定结构有效性。评估由主治外科医生、受过培训的观察者和操作员完成。
共完成了 25 名受训者和 4 名主治外科医生的 29 次评估。专家的评估得分明显高于新手操作员（p = 0.004）。第 4 和第 5 年住院医师的评分明显低于专家组（p <0.05），而第 6 年住院医师和主治外科医生的平均表现评分之间没有差异（p >0.05）。评估工具的内部一致性非常好（Cronbach 的 α 值为 0.90 至 0.93）。评分者之间的总体评估评分 ICC 为 0.80（95% CI 0.65-0.90）。
全球机器人手术技能评估工具易于管理，能够区分机器人手术专业知识水平。这种标准化的评估工具具有出色的一致性、可靠性和有效性。需要进一步研究来评估其在机器人手术教育和能力建立中的实用性。
