Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Canada.
Division of General Surgery, University Health Network (UHN), Toronto, Canada.
Surg Endosc. 2020 Jan;34(1):443-449. doi: 10.1007/s00464-019-06788-w. Epub 2019 Apr 29.
The fundamentals of laparoscopic surgery (FLS) program is a simulation-based training program designed to teach and assess the basic skills necessary for laparoscopic surgery. Preliminary work has demonstrated the feasibility of using Skype™ as a telesimulation modality in reliably scoring the exam for remote centers. Google Glass (GG) (Mountain View, California) is referred to as a wearable computer containing a heads-up display and front-facing camera allowing point-of-view video transmission. The objective of this study was to evaluate the feasibility of GG in scoring the technical skills component of the FLS exam.
Twenty-eight participants were asked to complete the peg transfer and intracorporeal knot tasks of FLS using both GG and Skype™ setups. GG employed a third-party HIPAA-compliant video software (Pristine; Austin, TX) for video transmission. Participants were alternated between setups and evaluated by onsite and remote proctors. Times and errors were recorded by both proctors. Interrater reliability of their FLS scores was compared using Intraclass Correlation Coefficients (ICCs). GG experience was evaluated based on participant survey responses using a 5-point Likert scale.
Interrater reliability for GG demonstrated a statistically significant correlation between onsite (OP) and remote (RP) proctors with ICCs of 0.985 (95% Confidence Interval [CI], 0.969-0.993) and 0.997 (95% CI 0.993-0.998), respectively, for peg and suture tasks. Skype™ demonstrated ICCs of 1.0 (95% CI 1.0-1.0). Average Likert scale responses found GG to be distracting (2.71), obstructive of the view (2.79), and a limitation to task execution (2.75). Overall, there was no statistical difference in scores between GG and Skype™ setups for either the peg (t = 1.446, p = 0.154) or suture task (t = - 0.710, p = 0.480), only 1 participant found the use of GG superior to Skype™.
Our findings suggest that although GG are feasible in remote assessment of FLS with strong interrater reliability (ICC > 0.95), Skype™ was the preferred modality.
腹腔镜手术基础（FLS）课程是一个基于模拟的培训项目，旨在教授和评估腹腔镜手术所需的基本技能。初步研究已经证明，使用 Skype™作为远程中心考试的远程模拟模式是可行的。Google Glass（GG）（加利福尼亚州山景城）被称为一种可穿戴计算机，包含抬头显示器和前置摄像头，允许传输视角视频。本研究的目的是评估 GG 在评分 FLS 考试技术技能部分的可行性。
要求 28 名参与者使用 GG 和 Skype™设置完成 peg 转移和腔内打结任务。GG 使用第三方符合 HIPAA 标准的视频软件（Austin，TX 的 Pristine）进行视频传输。参与者在设置之间交替，并由现场和远程监考人员进行评估。两位监考人员记录时间和错误。使用组内相关系数（ICC）比较他们 FLS 评分的评分者间可靠性。根据参与者的 5 分李克特量表调查回复评估 GG 经验。
GG 的评分者间可靠性显示，现场（OP）和远程（RP）监考人员之间具有统计学显著相关性，peg 和缝线任务的 ICC 分别为 0.985（95%置信区间 [CI]，0.969-0.993）和 0.997（95% CI 0.993-0.998）。Skype™的 ICC 为 1.0（95% CI 1.0-1.0）。平均李克特量表回复发现 GG 分散注意力（2.71）、妨碍视野（2.79）、限制任务执行（2.75）。总体而言，对于 peg（t=1.446，p=0.154）或缝线任务（t=-0.710，p=0.480），GG 和 Skype™设置之间的评分没有统计学差异，只有 1 名参与者认为 GG 优于 Skype™。
我们的研究结果表明，尽管 GG 在 FLS 的远程评估中具有很强的评分者间可靠性（ICC>0.95）是可行的，但 Skype™是首选模式。
