Department of Clinical Sciences, Malmö: Ophthalmology, Lund University, Malmö, Sweden.
Acta Ophthalmol. 2013 Aug;91(5):469-74. doi: 10.1111/j.1755-3768.2012.02440.x. Epub 2012 Jun 7.
To investigate construct validity for modules hydromaneuvers and phaco on the Eyesi surgical simulator.
Seven cataract surgeons and 17 medical students performed capsulorhexis, hydromaneuvers, phaco, navigation, forceps, cracking and chopping modules in a standardized manner. Three trials were performed on each module (two on phaco) in the above order. Performance parameters as calculated by the simulator for each trial were saved. Video recordings of the second trial of the modules capsulorhexis, hydromaneuvers and phaco were evaluated with the modified Objective Structured Assessment of Surgical Skill (OSATS) and Objective Structured Assessment of Cataract Surgical Skill (OSACSS) tools.
Cataract surgeons outperformed medical students with regard to overall score on capsulorhexis (p < 0.001, p = 0.035, p = 0.010 for the tree iterations, respectively), navigation (p = 0.024, p = 0.307, p = 0.007), forceps (p = 0.017, p = 0.03, p = 0.028). Less obvious differences in overall score were found for modules cracking and chopping (p = 0.266, p = 0.022, p = 0.324) and phaco (p = 0.011, p = 0.081 for the two iterations, respectively). No differences in overall score were found on hydromaneuvers (p = 0.588, p = 0.503, p = 0.773), but surgeons received better scores from the evaluations of the modified OSATS (p = 0.001) and OSACSS (capsulorhexis, p = 0.003; hydromaneuvers, p = 0.017; phaco, p = 0.001).
Construct validity was found on several modules previously not investigated (phaco, hydromaneuvers, cracking and chopping, navigation), and our results confirm previously demonstrated construct validity for capsulorhexis and forceps modules. Interestingly, validation of the hydromaneuvers module required OSACSS video evaluation tool. A further development of the scoring system in the simulator for the hydromaneuvers module would be advantageous and make training and evaluation of progress more accessible and immediate.
研究 Eyesi 手术模拟器中水力操作和超声乳化模块的结构效度。
7 名白内障外科医生和 17 名医学生以标准化方式进行了撕囊、水力操作、超声乳化、导航、器械夹持、劈裂和切碎模块的操作。每个模块（超声乳化进行两次）进行三次试验，按上述顺序进行。模拟器为每个试验计算的性能参数被保存。对撕囊、水力操作和超声乳化模块的第二次试验的视频记录，使用改良的客观结构化手术技能评估（OSATS）和客观结构化白内障手术技能评估（OSACSS）工具进行评估。
白内障外科医生在撕囊术的总体得分方面优于医学生（分别为三次试验中的 p<0.001、p=0.035、p=0.010）、导航（p=0.024、p=0.307、p=0.007）、器械夹持（p=0.017、p=0.03、p=0.028）。在劈裂和切碎模块（p=0.266、p=0.022、p=0.324）和超声乳化（分别为两次试验中的 p=0.011、p=0.081）的总体得分方面，差异不太明显。在水力操作方面，总体得分无差异（p=0.588、p=0.503、p=0.773），但外科医生在改良 OSATS 评估中得分更高（p=0.001）和 OSACSS（撕囊术，p=0.003；水力操作，p=0.017；超声乳化，p=0.001）。
在几个先前未研究过的模块（超声乳化、水力操作、劈裂和切碎、导航）上发现了结构效度，并且我们的结果证实了撕囊术和器械夹持模块先前已证明的结构效度。有趣的是，水力操作模块的验证需要 OSACSS 视频评估工具。模拟器中水力操作模块评分系统的进一步发展将是有利的，并且使培训和评估进展更加便捷和直接。
