Children's Hospital of Eastern Ontario. University of Ottawa.
J Pediatr Surg. 2013 Oct;48(10):2075-7. doi: 10.1016/j.jpedsurg.2013.01.039.
The Pediatric Laparoscopic Surgery (PLS) simulator is the only validated tool for pediatric Minimal Access Surgery. Construct validity (the ability to discriminate between novice, intermediate and expert) for the PLS simulator had previously been established on the basis of the total PLS score, as well as the individual performance on three of the five tasks. We describe the process and methods used to establish independent construct validity for a fourth task: pattern-cutting.
After considering various options for the possible modifications of the task itself, we retrospectively altered the way the pattern-cutting task was scored by modifying the weighting of precision versus time without changing the task itself. This was subsequently tested prospectively at the 2011 Canadian Association of Pediatric Surgeons meeting.
Modification in the scoring metrics allowed differentiation within a previously tested cohort of 84 candidates (20 novices: score=48 ± 16, 19 intermediates: score=59 ± 18, 45 experts: score=69 ± 12 p=0.01). This was validated prospectively in a cohort of 18 experts and 7 intermediates (65 ± 8, 54 ± 17 p=0.03).
Construct validity for the pattern-cutting task was established by modification of the scoring metrics. This was validated both retrospectively and prospectively.
儿科腹腔镜手术（PLS）模拟器是小儿微创外科唯一经过验证的工具。先前已经根据总 PLS 评分以及五项任务中的三项的个人表现，确定了 PLS 模拟器的结构效度（区分新手、中级和专家的能力）。我们描述了为第四个任务——模式切割建立独立结构效度的过程和方法。
在考虑了任务本身可能的修改的各种选项之后，我们通过修改精度与时间的权重而不改变任务本身，来回顾性地改变模式切割任务的评分方式。随后在 2011 年加拿大小儿外科学会会议上进行了前瞻性测试。
评分指标的修改使得在之前测试的 84 名考生队列中（20 名新手：分数=48±16，19 名中级生：分数=59±18，45 名专家：分数=69±12，p=0.01）能够进行区分。这在 18 名专家和 7 名中级生的队列中进行了前瞻性验证（65±8，54±17，p=0.03）。
通过修改评分指标，确立了模式切割任务的结构效度。这在回顾性和前瞻性研究中均得到了验证。
