Misaki Kouichi, Kamide Tomoya, Uno Takehiro, Tsutsui Taishi, Nambu Iku, Nakada Mitsutoshi
Department of Neurosurgery, Kanazawa University School of Medicine, Ishikawa, Japan.
Heliyon. 2023 Jan 27;9(2):e13249. doi: 10.1016/j.heliyon.2023.e13249. eCollection 2023 Feb.
Cerebral angiography is indispensable for endovascular neurosurgeons. However, there is no established system to evaluate the competency of trainees. We established a scoring system and statistically analyzed its characteristics.
Endovascular neurosurgeons scored the operators of 177 cerebral angiography based on ten evaluation items. Preoperative explanation, device selection, and device assembly were classified as "preparation," communication with the patient, radiation protection and angiography system as "attention," and catheter operation, blood loss, procedure completion, and sheath insertion as "skill". The sum of the scores were compared using the Mann-Whitney test according to the status of the operator (trainee (TR), neurosurgeon (NS), or endovascular neurosurgeon (EVNS)).
The highest average for each item was 0.89 for communication, and the lowest was 0.68 for catheter operation. The mean ± standard deviation of the total score was 7.82 ± 2.02, and scores by status were 7.08 ± 2.12 for TR, 8.32 ± 1.35 for NS, and 9.33 ± 1.20 for EVNS with significant differences among each status (p < 0.05). The sum scores of the preparation, attention, and skill sections also showed significant differences between each status except between NS and EVNS in the preparation section and TR and NS in the skill section (p < 0.05).
There were significant differences in the total score between statuses, suggesting that the scoring system may be an indicator of proficiency in cerebral angiography. It was suggested that dividing each item into preparation, attention, and skill sections may indicate the characteristics of proficiency.
脑血管造影术对于血管内神经外科医生来说必不可少。然而,目前尚无评估学员能力的既定系统。我们建立了一个评分系统并对其特征进行了统计分析。
血管内神经外科医生根据十个评估项目对177例脑血管造影术的操作者进行评分。术前解释、设备选择和设备组装被归类为“准备”,与患者的沟通、辐射防护和血管造影系统被归类为“注意”,导管操作、失血情况、手术完成情况和鞘管插入被归类为“技能”。根据操作者的状态(学员(TR)、神经外科医生(NS)或血管内神经外科医生(EVNS)),使用曼-惠特尼检验比较得分总和。
各项目的最高平均分在沟通方面为0.89,在导管操作方面最低,为0.68。总分的平均值±标准差为7.82±2.02,不同状态的得分分别为:TR为7.08±2.12,NS为8.32±1.35,EVNS为9.33±1.20,各状态之间存在显著差异(p<0.05)。准备、注意和技能部分的得分总和在各状态之间也显示出显著差异,但准备部分的NS和EVNS之间以及技能部分的TR和NS之间除外(p<0.05)。
不同状态之间的总分存在显著差异,表明该评分系统可能是脑血管造影术熟练程度的一个指标。建议将每个项目分为准备、注意和技能部分可能表明熟练程度的特征。