Sánchez-Fernández Javier, Bachiller-Burgos Jaime, Serrano-Pascual Alvaro, Cózar-Olmo José Manuel, Díaz-Güemes Idoia, Sánchez-Hurtado Miguel Angel, Moreno-Naranjo Belén, Enciso-Sanz Silvia, Correa-Martín Laura, Fernández-Tomé Blanca, Pérez-López María Mar, Alvarez-Ossorio José Luis, Sánchez-Margallo Francisco Miguel
Coordinador de Formación. Responsable de Calidad. Centro de Cirugía de Mínima Invasión Jesús Usón (CCMIJU). Cáceres. España.
Jefe Servicio Urología. Hospital San Juan de Dios del Aljarafe. Bormujos. Sevilla. España.
Arch Esp Urol. 2018 Jan;71(1):73-84.
Urology needs models of competencies assessment, although there is a wide range of tools not yet integrated into the official training programs.
At present, there is no universal framework for measuring surgeons' level of competence. Urology training programs should provide and consider knowledge, pyschomotor/cognitive skills, and simulator, cadaver or animal models-based training. Validity is a complex concept that refers to the capacity of the evaluation tool, so it is necessary to demonstrate several types of validation to assure the capacity of a method, reinforced with different reliability tests and calculation of internal consistency between evaluators.
Based on a structured dossier of surgical skills, classified by groups, the ESSCOLAP® Basic system was proposed with 5 simulator tasks to evaluate basic laparoscopic skills. Once validated in the JUMISC (Spain), the tool was proposed to extend its scope and implementation in other locations.
Our system has not yet demonstrated a full validity in the real clinical setting because a predictive validity needs to be demonstrated on the basis of clinical data. It also suffers from a certain range of subjectivity, thus implying clear and defined criteria for any situation. Factors like the number of evaluators and tasks to assess will influence the reliability tests that measure the degree of agreement between evaluators, so that a higher number of evaluated cases would imply a greater reliability of our system. Finally, we assume that the incorporation of this type of tools implies an added cost, charged to the public and private responsible institutions, which will only be considered cost-effective when it is demonstrated its real and positive traceability in health outcomes.
ESSCOLAP® Basic, of quick and simple implementation capacity, has been validated and calibrated for the evaluation of basic technical skills in laparoscopy.
泌尿外科需要能力评估模型，尽管有多种工具尚未纳入官方培训项目。
目前，尚无衡量外科医生能力水平的通用框架。泌尿外科培训项目应提供并考虑知识、心理运动/认知技能以及基于模拟器、尸体或动物模型的培训。效度是一个复杂的概念，指评估工具的能力，因此有必要展示多种类型的验证，以确保一种方法的能力，并通过不同的可靠性测试和评估者之间内部一致性的计算来加强。
基于按组分类的手术技能结构化档案，提出了ESSCOLAP®基础系统，包含5项模拟器任务以评估基本腹腔镜技能。该工具在西班牙的JUMISC验证后，提议扩大其在其他地区的应用范围和实施。
我们的系统在实际临床环境中尚未证明具有完全效度，因为需要根据临床数据证明预测效度。它还存在一定程度的主观性，因此意味着任何情况下都要有明确和确定的标准。评估者数量和要评估的任务等因素会影响衡量评估者之间一致性程度的可靠性测试，因此评估病例数量越多意味着我们系统的可靠性越高。最后，我们认为纳入这类工具意味着额外成本，由公共和私人责任机构承担，只有在证明其在健康结果方面具有真正的积极可追溯性时，才会被认为具有成本效益。
ESSCOLAP®基础系统实施快速简便，已通过验证和校准，用于评估腹腔镜基本技术技能。
