From the Department of Obstetrics and Gynecology.
Female Pelvic Med Reconstr Surg. 2022 Jan 1;28(1):14-19. doi: 10.1097/SPV.0000000000001054.
We sought to validate a simulation model for robotic sacrocolpopexy (RSCP) that includes multiple steps: presacral dissection/mesh attachment, vaginal mesh attachment, and peritoneal closure.
An RSCP training model was developed. Female pelvic medicine and reconstructive surgery (FPMRS) experts and current FPMRS fellows were videotaped using the model; sessions were timed and scored using the Global Evaluative Assessment of Robotic Skills (GEARS) by 3 surgeon reviewers masked to participants' identities. Construct validity was measured by comparing performance on the model between experts and trainees. Interrater reliability was determined by calculating intraclass correlation coefficients for total GEARS scores. Face validity was assessed by a postprocedure questionnaire.
Experts included 9 board-certified FPMRS physicians experienced in RSCP; trainees were 17 fellows. Experts practiced at 7 different institutions in the United States, and the majority (5/7) taught fellows. Trainees were from 7 institutions and in various years of training: postgraduate year (PGY) 5 (n = 6), PGY 6 (n = 5), and PGY 7 (n = 6). Experts' performances were rated significantly higher for total GEARS scores and for relevant domains of the GEARS scale. Intraclass correlation coefficient for the 3 reviewer pairs (0.96-0.99) indicated high interrater reliability. All participants "agreed/strongly agreed" that the model closely approximated live RSCP surgery and was useful for teaching and learning the procedure, indicating high face validity.
This novel, multistep simulation model demonstrated construct validity and high interrater reliability. Face validity was also established. Consequently, this RSCP model could be used for surgical training and assessment of these discrete surgical skill steps.
我们旨在验证一种包含多个步骤的机器人骶骨阴道固定术（RSCP）模拟模型：骶前解剖/网片固定、阴道网片固定和腹膜关闭。
开发了一种 RSCP 培训模型。使用该模型对女性盆底医学和重建外科（FPMRS）专家和当前 FPMRS 研究员进行录像；由 3 名外科医生评审员使用全球机器人技能评估量表（GEARS）对会话进行计时和评分，评审员对参与者的身份进行了盲评。通过比较专家和学员在模型上的表现来衡量结构有效性。通过计算总 GEARS 评分的组内相关系数来确定评分者间的可靠性。通过术后问卷评估表面有效性。
专家包括 9 名在美国具有 RSCP 经验的经过董事会认证的 FPMRS 医生；学员有 17 名。专家在 7 个不同的机构进行实践，其中 5 个（5/7）机构教授研究员。学员来自 7 个机构，处于不同的培训阶段：研究生第 5 年（PGY5，n=6）、PGY6（n=5）和 PGY7（n=6）。专家在总 GEARS 评分和 GEARS 量表的相关领域的表现评分显著更高。3 位评审员的组内相关系数（0.96-0.99）表明评分者间具有很高的可靠性。所有参与者均“同意/强烈同意”该模型非常接近实际的 RSCP 手术，并且对于教授和学习该手术程序非常有用，表明其具有很高的表面有效性。
这种新的、多步骤的模拟模型具有结构有效性和很高的评分者间可靠性。同时还确立了表面有效性。因此，这种 RSCP 模型可用于手术培训和评估这些离散的手术技能步骤。
