机器人客观结构化临床技能评估的有效性和可靠性。
Validity and reliability of the robotic Objective Structured Assessment of Technical Skills.
机构信息
Departments of Obstetrics and Gynecology, Duke University, Durham, North Carolina; Wright State University, Dayton, Ohio, the University of North Carolina, Chapel Hill, North Carolina; Johns Hopkins University, Baltimore, Maryland; Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lehigh Valley Health Network, Allentown, Pennsylvania; Newark Beth Israel Medical Center, Newark, New Jersey; and Cleveland Clinic, Cleveland, Ohio.
出版信息
Obstet Gynecol. 2014 Jun;123(6):1193-1199. doi: 10.1097/AOG.0000000000000288.
OBJECTIVE
Objective Structured Assessments of Technical Skills have been developed to measure the skill of surgical trainees. Our aim was to develop an Objective Structured Assessments of Technical Skills specifically for trainees learning robotic surgery.
METHODS
This is a multiinstitutional study conducted in eight academic training programs. We created an assessment form to evaluate robotic surgical skill through five inanimate exercises. Gynecology, general surgery, and urology residents, Fellows, and faculty completed five robotic exercises on a standard training model. Study sessions were recorded and randomly assigned to three blinded judges who scored performance using the assessment form. Construct validity was evaluated by comparing scores between participants with different levels of surgical experience; interrater and intrarater reliability were also assessed.
RESULTS
We evaluated 83 residents, nine Fellows, and 13 faculty totaling 105 participants; 88 (84%) were from gynecology. Our assessment form demonstrated construct validity with faculty and Fellows performing significantly better than residents (mean scores 89±8 faculty, 74±17 Fellows, 59±22 residents; P<.01). In addition, participants with more robotic console experience scored significantly higher than those with fewer prior console surgeries (P<.01). Robotic Objective Structured Assessments of Technical Skills demonstrated good interrater reliability across all five drills (mean Cronbach's α 0.79±0.02). Intrarater reliability was also high (mean Spearman's correlation 0.91±0.11).
CONCLUSION
We developed a valid and reliable assessment form for robotic surgical skill. When paired with standardized robotic skill drills, this form may be useful to distinguish between levels of trainee performance.
LEVEL OF EVIDENCE
II.
目的
客观结构化临床技能评估已被开发出来，以衡量外科学员的技能。我们的目的是开发一种专门用于学习机器人手术的学员的客观结构化临床技能评估。
方法
这是一项在 8 个学术培训项目中进行的多机构研究。我们创建了一个评估表，通过 5 项无生命的练习来评估机器人手术技能。妇科、普通外科和泌尿科住院医师、研究员和教员在标准培训模型上完成了 5 项机器人练习。研究课程被记录下来，并随机分配给 3 名盲评员，他们使用评估表对表现进行评分。通过比较不同手术经验水平的参与者之间的分数来评估构念效度；还评估了评分者间和评分者内的可靠性。
结果
我们评估了 105 名总共 83 名住院医师、9 名研究员和 13 名教员；88 名（84%）来自妇科。我们的评估表显示了构念效度，教员和研究员的表现明显优于住院医师（平均分数 89±8 名教员，74±17 名研究员，59±22 名住院医师；P<.01）。此外，具有更多机器人控制台经验的参与者的得分明显高于具有较少先前控制台手术的参与者（P<.01）。机器人客观结构化临床技能评估在所有 5 项练习中都具有良好的评分者间可靠性（平均 Cronbach's α 0.79±0.02）。评分者内可靠性也很高（平均 Spearman's 相关系数 0.91±0.11）。
结论
我们开发了一种用于机器人手术技能的有效且可靠的评估表。当与标准化的机器人技能训练相结合时，该表格可能有助于区分学员的表现水平。
证据水平
II。
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