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一种评估胸腔镜肺叶切除术能力的新评估工具。

A novel assessment tool for evaluating competence in video-assisted thoracoscopic surgery lobectomy.

机构信息

Department of Cardiothoracic Surgery 2152, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.

Copenhagen Academy for Medical Education and Simulation (CAMES) 5404, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.

出版信息

Surg Endosc. 2018 Oct;32(10):4173-4182. doi: 10.1007/s00464-018-6162-8. Epub 2018 Mar 30.

Abstract

BACKGROUND

Specific assessment tools can accelerate trainees' learning through structured feedback and ensure that trainees attain the knowledge and skills required to practice as competent, independent surgeons (competency-based surgical education). The objective was to develop an assessment tool for video-assisted thoracoscopic surgery (VATS) lobectomy by achieving consensus within an international group of VATS experts.

METHOD

The Delphi method was used as a structured process for collecting and distilling knowledge from a group of internationally recognized VATS experts. Opinions were obtained in an iterative process involving answering repeated rounds of questionnaires. Responses to one round were summarized and integrated into the next round of questionnaires until consensus was reached.

RESULTS

Thirty-one VATS experts were included and four Delphi rounds were conducted. The response rate for each round were 68.9% (31/45), 100% (31/31), 96.8% (30/31), and 93.3% (28/30) for the final round where consensus was reached. The first Delphi round contained 44 items and the final VATS lobectomy Assessment Tool (VATSAT) comprised eight items with rating anchors: (1) localization of tumor and other pathological tissue, (2) dissection of the hilum and veins, (3) dissection of the arteries, (4) dissection of the bronchus, (5) dissection of lymph nodes, (6) retrieval of lobe in bag, (7) respect for tissue and structures, and (8) technical skills in general.

CONCLUSION

A novel and dedicated assessment tool for VATS lobectomy was developed based on VATS experts' consensus. The VATSAT can support the learning of VATS lobectomy by providing structured feedback and help supervisors make the important decision of when trainees have acquired VATS lobectomy competencies for independent performance.

摘要

背景

特定的评估工具可以通过结构化反馈加速学员的学习,并确保学员获得作为有能力、独立外科医生所需的知识和技能(以能力为基础的外科教育)。目的是通过在国际胸腔镜外科专家小组内达成共识,开发一种用于胸腔镜肺叶切除术(VATS)的评估工具。

方法

德尔菲法被用作一种从一组国际认可的胸腔镜外科专家那里收集和提炼知识的结构化过程。意见是通过一个迭代过程获得的,包括回答几轮重复的问卷。对上一轮的回答进行总结,并整合到下一轮的问卷中,直到达成共识。

结果

共纳入 31 名胸腔镜外科专家,并进行了四轮德尔菲法。每轮的回复率分别为 68.9%(31/45)、100%(31/31)、96.8%(30/31)和最后一轮的 93.3%(28/30),最终达成共识。第一轮德尔菲法包含 44 个项目,最终的胸腔镜肺叶切除术评估工具(VATSAT)包含 8 个项目,带有评分锚点:(1)肿瘤和其他病变组织的定位,(2)肺门和静脉的解剖,(3)动脉的解剖,(4)支气管的解剖,(5)淋巴结的解剖,(6)将肺叶放入袋中,(7)对组织和结构的尊重,以及(8)一般的技术技能。

结论

基于胸腔镜外科专家的共识,开发了一种新的专门用于胸腔镜肺叶切除术的评估工具。VATSAT 可以通过提供结构化反馈来支持胸腔镜肺叶切除术的学习,并帮助主管人员做出重要决定,即学员何时获得独立进行胸腔镜肺叶切除术的能力。

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