Teaching Vaginal Surgery to Junior Residents: Initial Validation of 3 Novel Procedure-Specific Low-Fidelity Models

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• 作者：Roxana Geoffrion ; MDCM ; FRCSC^⁎ ; ^{roxygeo@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Michael W. Suen ; MD^⁎ ; Nicole A. Koenig ; BA^⁎ ; Paul Yong ; MD ; FRCSC^⁎ ; Erin Brennand ; MD ; FRCSC^&dagger ; ; Neeraj Mehra ; MD ; FRCSC^⁎ ; Maryse Larouche ; MD ; FRCSC^⁎ ; Terry Lee ; PhD^⁎ ; Nicole J. Todd ; MD ; FRCSC^⁎
• 关键词：low fidelity simulation ; vaginal surgery ; junior residents
• 刊名：Journal of Surgical Education
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：73
• 期：1
• 页码：157-161
• 全文大小：350 K

文摘

Competency-based surgical education relies on operative models to teach surgical skills within a curriculum. Low fidelity simulation has been shown to improve surgical performance. Our objectives were: to develop procedure-specific models to teach anterior repair (AR), posterior repair (PR), and vaginal hysterectomy (VH) to junior residents; to establish model reliability and validity.

Design

Residents were randomized to control (no training) and intervention (model training) groups. They were filmed while performing a series of tasks. Experts were also filmed. Each video was scored by 2 blinded raters.

Setting

Multicenter collaboration within the Western Society of Pelvic Medicine (Vancouver, Calgary, and Edmonton). Face and content validity were evaluated. A standard scoring tool was developed for performance evaluation. Interrater reliability was assessed using intraclass correlation coefficient. Cronbach α was calculated for internal consistency. Jonckheere-Terpstra test verified whether the scores increased with operator skill level.

Participants

A total of 14 junior gynecology residents, 2 urogynecology fellows, and 3 staff urogynecologists were rated by a total of 6 gynecologic surgeons who scored 42 videos each.

Results

Experienced pelvic surgeons from 3 participating sites agreed the models captured essential elements of real surgical skills (face validity) and of the true procedures (content validity). Intraclass correlation coefficient was adequate (AR = 0.86, PR = 0.90, and VH = 0.87). Cronbach α for the total scores was adequate (AR = 0.85, PR = 0.8, and VH = 0.71). Performance score increased with operator skill level for all 3 procedures (AR, p = <0.001; PR, p = 0.008; and VH, p = 0.007).

Conclusions

Our low fidelity procedure-specific vaginal surgery models had adequate initial validity. Future research will investigate transferability of acquired skills to the operating room.