Al-Jabir Ahmed, Aydin Abdullatif, Abe Takashige, Raison Nicholas, Khan M Shamim, Dasgupta Prokar, Ahmed Kamran
MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
MRC Centre for Transplantation, King's College London, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
Urology. 2017 Dec;110:45-50. doi: 10.1016/j.urology.2017.07.047. Epub 2017 Aug 18.
To validate the Advanced Scope Trainer (AST; Mediskills, Northampton, UK). The AST is a currently unvalidated simulator, developed for flexible ureterorenoscopy (fURS) training. This study aims to assess the face, content, construct, and concurrent validity to assess the level of transferability of skills to the operating room.
This prospective, observational, and comparative study recruited novices (n = 19) and trainees (n = 34), with participants performing a diagnostic fURS, followed by removal of a lower pole stone, on the AST. Fifteen participants performed a fURS on fresh frozen cadavers to assess concurrent validity. Trainees were supervised by expert urologists (n = 7) during each procedure. Performance was evaluated using the validated Objective Structured Assessment of Technical Skills (OSATS) assessment. Face and content validity were demonstrated by anonymous surveys from participants and faculty.
Face validity assessment revealed that trainees found the simulator was 76% realistic (3.8/5 on a Likert scale). Laser stone fragmentation (4.11 ± 0.85) and manual stone extraction (4.03 ± 0.85) were thought to be the most realistic components and guidewire insertion (3.14 ± 1.35) the least. Participants also believed the simulator to be useful, giving transferrable skills to take into the operating room, demonstrating content validity. Using an OSATS assessment, concurrent validity was demonstrated in "respect for tissue" (P = .0105) and "time and motion" (P = .0196). Construct validity was also demonstrated when comparing novices to trainees (mean OSATS 10.11 ± 2.28 vs 23.89 ± 5.38).
This study has demonstrated face, content, construct, and concurrent validity of the AST for fURS training. Further evaluation is necessary to demonstrate construct and predictive validity of skills gained using the model.
验证高级内镜训练器（AST；Mediskills，英国北安普敦）。AST是一种目前未经验证的模拟器，专为柔性输尿管肾镜检查（fURS）培训而开发。本研究旨在评估其表面效度、内容效度、结构效度和同时效度，以评估技能向手术室的可转移性水平。
这项前瞻性、观察性和对比性研究招募了新手（n = 19）和学员（n = 34），参与者在AST上进行诊断性fURS，随后取出下极结石。15名参与者在新鲜冷冻尸体上进行fURS以评估同时效度。在每个操作过程中，学员由泌尿外科专家（n = 7）监督。使用经过验证的客观结构化技术技能评估（OSATS）对操作表现进行评估。通过参与者和教员的匿名调查证明表面效度和内容效度。
表面效度评估显示，学员认为模拟器的逼真度为76%（李克特量表评分为3.8/5）。激光碎石（4.11±0.85）和手动取石（4.03±0.85）被认为是最逼真的部分，而导丝插入（3.14±1.35）最不逼真。参与者还认为模拟器有用，能提供可转移至手术室的技能，证明了内容效度。使用OSATS评估，在“组织尊重”（P = 0.0105）和“时间与动作”（P = 0.0196）方面证明了同时效度。在比较新手和学员时（平均OSATS 10.11±2.28对23.89±5.38）也证明了结构效度。
本研究证明了AST用于fURS培训的表面效度、内容效度、结构效度和同时效度。需要进一步评估以证明使用该模型获得的技能的结构效度和预测效度。
