Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Surgical Foundations, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Clin Anat. 2023 Jul;36(5):754-763. doi: 10.1002/ca.24037. Epub 2023 Apr 3.
Human cadavers used for surgical training are embalmed using various methods to facilitate tissue storage and longevity while preserving the natural characteristics required to achieve high fidelity functional task alignment. However, there are no standardized means to evaluate the suitability of embalming solutions for this purpose. The McMaster Embalming Scale (MES) was developed to assess the extent to which embalming solutions allow tissues to achieve physical and functional correspondence to clinical contexts. The MES follows a five-point Likert scale format and evaluates the effect of embalming solutions on tissue utility in seven domains. This study aims to determine the reliability and validity of the MES by presenting it to users after performing surgical skills on tissues embalmed using various solutions. A pilot study of the MES was conducted using porcine material. Surgical residents of all levels and faculty were recruited via the Surgical Foundations program at McMaster University. Porcine tissue was unembalmed (fresh- frozen) or embalmed using one of seven solutions identified in the literature. Participants were blinded to the embalming method as they completed four surgical skills on the tissue. After each performance, participants evaluated their experience using the MES. Internal consistency was evaluated using Cronbach's alpha. Domain to total correlations and a g-study were also conducted. Formalin-fixed tissue achieved the lowest average scores, while fresh frozen tissue achieved the highest. Tissues preserved using Surgical Reality Fluid (Trinity Fluids, LLC, Harsens Island, MI) achieved the highest scores among embalmed tissues. The Cronbach's alpha scores varied between 0.85 and 0.92, indicating a random sample of new raters would offer similar ratings using the MES. All domains except odor were positively correlated. The g-study indicated that the MES is able to differentiate between embalming solutions, but an individual rater's preference for certain tissue qualities also contributes to the variance in scores captured. This study evaluated the psychometric characteristics of the MES. Future steps to this investigation include validating the MES on human cadavers.
用于外科培训的人体标本采用各种方法进行防腐处理，以方便组织储存和延长寿命，同时保持实现高保真功能任务对准所需的自然特征。然而，目前还没有标准化的方法来评估这些防腐处理溶液是否适合该用途。麦克马斯特防腐处理量表（MES）是为了评估防腐处理溶液在多大程度上允许组织在物理和功能上与临床环境相匹配而开发的。MES 采用五点 Likert 量表格式，从七个领域评估防腐处理溶液对组织实用性的影响。本研究旨在通过在使用各种溶液进行防腐处理的组织上进行外科技能操作后向用户展示 MES，以确定其可靠性和有效性。本研究使用猪材料进行了 MES 的初步研究。通过麦克马斯特大学的外科基础课程招募了各级外科住院医师和教员。猪组织未经防腐处理（新鲜冷冻）或使用文献中确定的七种溶液之一进行防腐处理。参与者在完成四项组织外科技能时对防腐处理方法一无所知。每次操作后，参与者使用 MES 评估他们的经验。使用 Cronbach 的 alpha 评估内部一致性。还进行了域间总相关性和 g 研究。福尔马林固定组织的平均得分最低，而新鲜冷冻组织的平均得分最高。使用外科现实液（三一流体，LLC，密歇根州哈森斯岛）保存的组织在防腐组织中得分最高。Cronbach 的 alpha 得分在 0.85 到 0.92 之间，这表明使用 MES 的新评分者的随机样本将提供类似的评分。除了气味外，所有领域都呈正相关。g 研究表明，MES 能够区分防腐处理溶液，但评分差异也归因于单个评分者对某些组织质量的偏好。本研究评估了 MES 的心理测量特征。下一步将在人体标本上验证 MES。
