胸腔镜食管闭锁/气管食管瘘修复模拟器中各项措施的验证。
Validation of measures from a thoracoscopic esophageal atresia/tracheoesophageal fistula repair simulator.
机构信息
Division of Pediatric Surgery, Ann and Robert H Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Center for Simulation Technology and Immersive Learning, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA.
出版信息
J Pediatr Surg. 2014 Jan;49(1):29-32; discussion 32-3. doi: 10.1016/j.jpedsurg.2013.09.069. Epub 2013 Nov 27.
PURPOSE
A validated high fidelity simulation model would provide a safe environment to teach thoracoscopic EA/TEF repair to novices. The study purpose was to evaluate validity evidence for performance measures on an EA/TEF simulator.
METHODS
IRB-exempt data were collected from 12 self-reported "novice" and 8 "experienced" pediatric surgeons. Participants evaluated the EA/TEF repair simulator using survey ratings that were analyzed for test content validity evidence. Additionally, deidentified operative performances were videotaped and independently rated by two surgeons using the Objective Structured Assessment for Technical Skills (OSATS) instrument. Novice and experienced OSATS were compared with p<.05 significant.
RESULTS
Participants had high overall simulator ratings. Internal structure was supported by high interitem consistency (α=.95 and .96) and interrater agreement (ICC) [.52, .84] for OSATS ratings. Experienced surgeons performed at a significantly higher level than novices for all five primary and two supplemental OSATS items (p<.05).
CONCLUSION
Favorable participant ratings indicate the simulator is relevant to clinical practice and valuable as a learning tool. Further, performance ratings can discriminate experienced and novice performances of EA/TEF repair. These findings support the use of the simulator for performance assessment, representing the first validated measures from a simulator intended for pediatric surgical training.
目的
经过验证的高保真模拟模型将为新手提供一个安全的环境来教授胸腔镜 EA/TEF 修复术。本研究旨在评估 EA/TEF 模拟器上的绩效测量的有效性证据。
方法
从 12 名自我报告的“新手”和 8 名“有经验”的儿科外科医生中收集了豁免 IRB 的数据。参与者使用调查评分评估 EA/TEF 修复模拟器，这些评分经过分析以获得测试内容有效性证据。此外，将未经身份识别的手术表现录制下来，并由两名外科医生使用客观结构化评估技术技能 (OSATS) 工具进行独立评分。新手和有经验的 OSATS 之间的比较具有统计学意义（p<.05）。
结果
参与者对模拟器的总体评价很高。内部结构得到了高内部一致性（α=.95 和.96）和 OSATS 评分的评分者间一致性（ICC）[.52，.84]的支持。与新手相比，所有五项主要和两项补充 OSATS 项目的经验丰富的外科医生的表现水平均显著更高（p<.05）。
结论
参与者的好评表明该模拟器与临床实践相关，并且是一种有价值的学习工具。此外，绩效评分可以区分 EA/TEF 修复的经验丰富和新手的表现。这些发现支持使用模拟器进行绩效评估，这代表了旨在用于儿科手术培训的模拟器的首批经过验证的措施。
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