Department of Pediatric Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Pediatric Surgery, Princess Maxima Center for Pediatric Oncology, Utrecht, Utrecht, the Netherlands.
Eur J Pediatr Surg. 2022 Oct;32(5):399-407. doi: 10.1055/s-0041-1736387. Epub 2021 Nov 25.
The correction of an anorectal malformation (ARM) is complex and relatively infrequent. Simulation training and subsequent assessment may result in better clinical outcomes. Assessment can be done using a competency assessment tool (CAT). This study aims to develop and validate a CAT for the posterior sagittal anorectoplasty (PSARP) on a simulation model.
The CAT-PSARP was developed after consultation with experts in the field. The PSARP was divided into five steps, while tissue and instrument handling were scored separately. Participants of pediatric colorectal hands-on courses in 2019 and 2020 were asked to participate. They performed one PSARP procedure on an ARM simulation model, while being assessed by two objective observers using the CAT-PSARP.
A total of 82 participants were enrolled. A fair interobserver agreement was found for general skills (intraclass correlation coefficient [ICC] = 0.524, < 0.001), a good agreement for specific skills (ICC = 0.646, < 0.001), and overall performance (ICC = 0.669, < 0.001). The experienced group scored higher on all steps ( < 0.001), except for "anoplasty ( = 0.540)," compared with an inexperienced group.
The CAT-PSARP is a suitable objective assessment tool for the overall performance of the included steps of the PSARP for repair of an ARM on a simulation model.
肛门直肠畸形（ARM）的矫正较为复杂，且相对少见。模拟训练和后续评估可能会带来更好的临床效果。评估可以使用能力评估工具（CAT）进行。本研究旨在开发和验证一种针对模拟模型中后矢状入路肛门直肠成形术（PSARP）的 CAT。
CAT-PSARP 是在与该领域专家协商后开发的。PSARP 被分为五个步骤，同时对组织和器械处理分别进行评分。2019 年和 2020 年，参加小儿结直肠实践课程的学员被邀请参加。他们在 ARM 模拟模型上完成一次 PSARP 手术，由两名客观观察者使用 CAT-PSARP 进行评估。
共纳入 82 名参与者。一般技能的观察者间具有中等一致性（组内相关系数 [ICC] = 0.524， < 0.001），特定技能的观察者间具有良好一致性（ICC = 0.646， < 0.001），整体表现的观察者间具有良好一致性（ICC = 0.669， < 0.001）。与无经验组相比，经验组在所有步骤的得分均更高（ < 0.001），除了“肛门成形术（ = 0.540）”。
CAT-PSARP 是一种适用于模拟模型中 ARM 修复的 PSARP 包括步骤的整体表现的客观评估工具。
