The reliability of task-specific metrics to assess resident performance on a robotic simulated pancreatojejunostomy
摘要
Global assessment scales of surgical technical performance are well documented; however, evidence supporting task-specific metrics (TSM) is limited. This study evaluates the utility of TSM developed for simulated robotic pancreatojejunostomies on bio-tissue.
MethodsFifty videos of bio-tissue pancreatojejunostomies performed by residents as part of our robotic curriculum were graded using both the Objective Structured Assessment of Technical Skills (OSATS) and a TSM scale consisting of 6 domains by a trained blinded grader. Messick’s validity framework was used to assess the utility of the TSM. The internal structure validity was established by computing inter-rater reliability using the intraclass correlation coefficient (ICC) on a subset of 10 videos assessed by an additional grader. Using blinded graders established the response process. Weighted total TSM scores were calculated with partial least squares (PLS) regression, and the Spearman’s Rank correlation with OSATS established the relations to other variables.
ResultsICC was 0.74 for OSATS and 0.95 for TSM scores. Mean total scores for OSATS were 25.48 ± 3.27 and 51.32 ± 5.8 for TSM. Prior to PLS regression, a strong correlation was observed between OSATS and TSM scores (R = 0.86, R2 = 0.78; p < 0.001). After regression, the computed weights were 0.29 for posterior mattress suture, 0.49 for posterior row of pancreatic duct sutures, 1.07 for duct stent placement, 0.47 for anterior row of duct sutures, and 0.3 for anterior seromuscular stitches. After regression, the correlation between the TSM weighted sum and OSATS scores was significantly improved (R = 0.88, R2 = 0.82; p < 0.001).
ConclusionTSM scores can be an effective and reliable tool to assess resident performance. They can also be used to provide feedback to surgical trainees.