Alwaal Amjad, Al-Qaoud Talal M, Haddad Richard L, Alzahrani Tarek M, Delisle Josee, Anidjar Maurice
Department of Surgery, Division of Urology, McGill University Health Centre, Montreal, Quebec, Canada ; Department of Urology, King Abdul Aziz University, Jeddah, Saudi Arabia.
Department of Surgery, Division of Urology, McGill University Health Centre, Montreal, Quebec, Canada.
Urol Ann. 2015 Apr-Jun;7(2):172-6. doi: 10.4103/0974-7796.150475.
Assessing the predictive validity of the LapSim simulator within a urology residency program.
Twelve urology residents at McGill University were enrolled in the study between June 2008 and December 2011. The residents had weekly training on the LapSim that consisted of 3 tasks (cutting, clip-applying, and lifting and grasping). They underwent monthly assessment of their LapSim performance using total time, tissue damage and path length among other parameters as surrogates for their economy of movement and respect for tissue. The last residents' LapSim performance was compared with their first performance of radical nephrectomy on anesthetized porcine models in their 4(th) year of training. Two independent urologic surgeons rated the resident performance on the porcine models, and kappa test with standardized weight function was used to assess for inter-observer bias. Nonparametric spearman correlation test was used to compare each rater's cumulative score with the cumulative score obtained on the porcine models in order to test the predictive validity of the LapSim simulator.
The kappa results demonstrated acceptable agreement between the two observers among all domains of the rating scale of performance except for confidence of movement and efficiency. In addition, poor predictive validity of the LapSim simulator was demonstrated.
Predictive validity was not demonstrated for the LapSim simulator in the context of a urology residency training program.
评估LapSim模拟器在泌尿外科住院医师培训项目中的预测效度。
2008年6月至2011年12月期间，麦吉尔大学的12名泌尿外科住院医师参与了该研究。住院医师每周接受LapSim培训，培训包括3项任务（切割、夹闭以及提起和抓取）。他们每月接受LapSim操作评估，评估指标包括总时间、组织损伤和路径长度等，这些指标可作为其动作经济性和对组织保护情况的替代指标。将住院医师最后一次LapSim操作表现与其在培训第4年时在麻醉猪模型上首次进行根治性肾切除术的表现进行比较。两名独立的泌尿外科医生对住院医师在猪模型上的操作表现进行评分，并使用带有标准化权重函数的kappa检验来评估观察者间偏差。使用非参数斯皮尔曼相关性检验比较每位评分者的累积分数与在猪模型上获得的累积分数，以测试LapSim模拟器的预测效度。
kappa结果显示，除了动作信心和效率外，在操作表现评分量表的所有领域中，两名观察者之间的一致性均可接受。此外，LapSim模拟器的预测效度较差。
在泌尿外科住院医师培训项目中，未证实LapSim模拟器具有预测效度。
