856 EXTERNAL VALIDATION OF THE GLOBAL EVALUATIVE ASSESSMENT OF ROBOTIC SKILLS

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment/Ureteroscopy I1 Apr 2012856 EXTERNAL VALIDATION OF THE GLOBAL EVALUATIVE ASSESSMENT OF ROBOTIC SKILLS Isuru Jayaratna, Andrew J. Hung, Kara Teruya, Casey K. Ng, Mihir M. Desai, Indebir S. Gill, and Alvin C. Goh Isuru JayaratnaIsuru Jayaratna Los Angeles, CA More articles by this author , Andrew J. HungAndrew J. Hung Los Angeles, CA More articles by this author , Kara TeruyaKara Teruya Los Angeles, CA More articles by this author , Casey K. NgCasey K. Ng Los Angeles, CA More articles by this author , Mihir M. DesaiMihir M. Desai Los Angeles, CA More articles by this author , Indebir S. GillIndebir S. Gill Los Angeles, CA More articles by this author , and Alvin C. GohAlvin C. Goh Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.949AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A critical companion to robotic surgical training is a validated assessment tool of robotic skills, utilized to determine clinical competency and to monitor skills improvement. The Global Evaluative Assessment of Robotic Skills (GEARS) is a clinical assessment tool for robotic surgical skills, previously developed and validated at an outside institution. We present external construct validation of this assessment tool at our institution. METHODS During a single event, 43 participants completed a standardized in-vivo task using the da Vinci® surgical robot in a porcine model. Experts (n=10) were defined as having completed >30 robotic cases as primary surgeon, while novices (n=33) were defined as having completed <30 cases. The objective of the task was to suture together a loop of bowel to the peritoneum overlying the kidney, secured by a square knot. Performance was independently evaluated using GEARS by two expert robotic surgeons and each participant. The GEARS performance scores were compared using the Kruskal-Wallis test. Interobserver reliability and internal consistency was measured using Spearman correlation and Cronbach's alpha, respectively. RESULTS Novices (median age 30 (28-41) years) and experts (median age 43 (34-53) years) had a median number of 0 (0-20) cases and 300 (30-2000) cases as primary surgeon for robotic surgeries, respectively. Experts demonstrated superior performance compared to novices overall and in all individual domains (p<0.0001). Inter-observer reliability between expert ratings was confirmed with a strong correlation observed (r=0.87, p<0.0001). Experts and participant scoring showed less agreement (r=0.48; r=0.51). Internal consistency was excellent for experts and participants (α=0.96, 0.98, 0.93). Omitting each item did not increase internal consistency. CONCLUSIONS In this study, the ability of GEARS to differentiate between novices and experts was confirmed. The internal consistency of GEARS was established for all scorers, but interobserver reliability was only observed between expert scorers, with deviation noted when including the participant self-scoring. Further validation of GEARS in the clinical setting amongst various procedures and sub-specialties is needed to establish its universal application in robotic surgery. Table 1. GEARS Performance Scores Novices Experts p Value Median (range) Median (range) GEARS Overall 20.5(12-28) 30(22-35) <0.0001 Depth Perception 3.5(2.5-4.5) 5(3.5-5) <0.0001 Bimanual Dexterity 3(1-5) 5(3.5-5) <0.0001 Efficiency 3(1-4.5) 5(3-5) <0.0001 Force Sensitivity 3(1-4.5) 5(3.5-5) <0.0001 Autonomy 3.5(2-5) 5(4-5) <0.0001 Robotic Control 3.5(2-4.5) 5(3.5-5) <0.0001 © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e349 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Isuru Jayaratna Los Angeles, CA More articles by this author Andrew J. Hung Los Angeles, CA More articles by this author Kara Teruya Los Angeles, CA More articles by this author Casey K. Ng Los Angeles, CA More articles by this author Mihir M. Desai Los Angeles, CA More articles by this author Indebir S. Gill Los Angeles, CA More articles by this author Alvin C. Goh Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...