PD19-04 VALIDATION OF LAPAROSCOPIC TRAINING CURRICULUM: THE BASIC LAPAROSCOPIC UROLOGIC SKILLS (BLUS) INITIATIVE

Abstract

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment III1 Apr 2015PD19-04 VALIDATION OF LAPAROSCOPIC TRAINING CURRICULUM: THE BASIC LAPAROSCOPIC UROLOGIC SKILLS (BLUS) INITIATIVE Timothy Kowalewski, Robert Sweet, Ashleigh Menhadji, Timothy Averch, Geoffrey Box, Timothy Brand, Michael Fearrandino, Jihad Kaouk, Bodo Knudsen, Jamie Landman, Benjamin Lee, Bradley Schwartz, Elspeth McDougall, and Thomas Lendvay Timothy KowalewskiTimothy Kowalewski More articles by this author , Robert SweetRobert Sweet More articles by this author , Ashleigh MenhadjiAshleigh Menhadji More articles by this author , Timothy AverchTimothy Averch More articles by this author , Geoffrey BoxGeoffrey Box More articles by this author , Timothy BrandTimothy Brand More articles by this author , Michael FearrandinoMichael Fearrandino More articles by this author , Jihad KaoukJihad Kaouk More articles by this author , Bodo KnudsenBodo Knudsen More articles by this author , Jamie LandmanJamie Landman More articles by this author , Benjamin LeeBenjamin Lee More articles by this author , Bradley SchwartzBradley Schwartz More articles by this author , Elspeth McDougallElspeth McDougall More articles by this author , and Thomas LendvayThomas Lendvay More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.703AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Standard basic laparoscopic training is required for urologic trainees to ensure proficiency prior to graduation from residency. The American Urological Association created the Basic Laparoscopic Urologic Skills (BLUS) skills tasks as an objective assessment tool to determine laparoscopic skills proficiency. We sought to establish construct validity of the psychomotor skills portion of this curriculum using objective performance metrics and structured assessment by video review. METHODS After IRB approval, eight US medical teaching institutions contributed 117 subjects of varying skill from medical student to full-time faculty urologist. All subjects performed four dry-lab laparoscopic tasks: Peg Transfer, Cutting, Intracorporeal Suturing, and Clip Applying. The Electronic Data Generation and Evaluation (EDGE) laparoscopic platform (Simulab Corp, Seattle WA) recorded synchronized video and tool motion metrics for all tasks along with proctor-entered task errors. Skill levels were assigned by both demographically-derived status (training level) and blinded video review by five faculty urologists employing the Global Objective Assessment of Laparoscopic Skills (GOALS) instrument for a representative subset of the database (12 Suturing, 12 Peg Transfer; maximum, median, and minimum task times). We employed Pearson's correlation to evaluate agreement between metrics and ground truth. RESULTS Using the structured assessment tool – GOALS – provided skill discrimination. Demographically-derived assignments were less correlated with skill. Task time, path length, and motion smoothness (jerk cost) correlated with ground truth structured video assessment (-0.69, -0.69 -0.79 respectively) for Peg Transfer and (-0.86, -0.91 -0.84 respectively) for Suturing (p<0.01). Inter-rater reliability of the five experienced faculty GOALS reviewers was >0.9. CONCLUSIONS The BLUS Peg Transfer and Intracorporeal Suturing skill tasks showed good construct validity based on a consensus of established objective performance metrics and blinded video review by experienced faculty. Training level or case experience alone may be inadequate to assign proficiency levels, thus more objective quantification of skill is required for advancement strategies in training centers. Table 1. Correlation of GOALS scores provided by five expert laparoscopists and EDGE objective performance metrics. Expert GOALS Assessments vs. Tool Metrics Peg Transfer Task Suturing Task N=24, Pearsons R n=12 n=12 R (p-value) R (p-value) EDGE Overall Score 0.95 (0.00) 0.95 (0.00) Task Time -0.91 (0.00) -0.95 (0.00) Tool Path Length -0.95 (0.00) -0.81 (0.00) Jerk Cost -0.63 (0.03) -0.82 (0.00) Movement Count -0.94 (0.00) -0.72 (0.01) Grasp Force NS NS Max Grasp Force NS NS Economy of Motion 0.62 (0.03) NS Errors -0.68 (0.02) 0.62 (0.03) © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e392-e393 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy Kowalewski More articles by this author Robert Sweet More articles by this author Ashleigh Menhadji More articles by this author Timothy Averch More articles by this author Geoffrey Box More articles by this author Timothy Brand More articles by this author Michael Fearrandino More articles by this author Jihad Kaouk More articles by this author Bodo Knudsen More articles by this author Jamie Landman More articles by this author Benjamin Lee More articles by this author Bradley Schwartz More articles by this author Elspeth McDougall More articles by this author Thomas Lendvay More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...