The left upper lobe challenge in video-assisted thoracoscopic surgery-use of a composite score to improve the assessment of simulated lobectomy.

Autor:	Haidari TA; Department of Cardiothoracic Surgery, University Hospital of Copenhagen-Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Bjerrum F; Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.; Copenhagen Academy for Medical Education and Simulation, Center for Human Resources and Education, Copenhagen, Denmark., Grimstrup S; Copenhagen Academy for Medical Education and Simulation, Center for Human Resources and Education, Copenhagen, Denmark., Christensen TD; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Vad H; Department of Cardiothoracic Surgery, University Hospital of Copenhagen-Rigshospitalet, Copenhagen, Denmark., Møller LB; Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark., Hansen HJ; Department of Cardiothoracic Surgery, University Hospital of Copenhagen-Rigshospitalet, Copenhagen, Denmark., Konge L; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Copenhagen Academy for Medical Education and Simulation, Center for Human Resources and Education, Copenhagen, Denmark., Petersen RH; Department of Cardiothoracic Surgery, University Hospital of Copenhagen-Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2022 Nov 03; Vol. 62 (6).
DOI:	10.1093/ejcts/ezac465
Abstrakt:	Aim: The aim of this study is to develop a reliable composite score based on simulator metrics to assess competency in virtual reality video-assisted thoracoscopic surgery lobectomy and explore the benefits of combining it with expert rater assessments. Methods: Standardized objective assessments (time, bleeding, economy of movement) and subjective expert rater assessments from 2 previous studies were combined. A linear mixed model including experience level, lobe and the number of previous simulated procedures was applied for the repeated measurements. Reliability for each of the 4 assessments was calculated using Cronbach's alpha. The Nelder-Mead numerical optimization algorithm was used for optimal weighting of scores. A pass-fail standard for the composite score was determined using the contrasting groups' method. Results: In total, 123 virtual reality video-assisted thoracoscopic surgery lobectomies were included. Across the 4 different assessments, there were significant effects (P < 0.01) of experience, lobe, and simulator experience, but not for simulator attempts on bleeding (P = 0.98). The left upper lobe was significantly more difficult compared to other lobes (P = 0.02). A maximum reliability of 0.92 could be achieved by combining the standardized simulator metrics with standardized expert rater scores. The pass/fail level for the composite score when including 1 expert rater was 0.33. Conclusions: Combining simulator metrics with 1 or 2 raters increases reliability and can serve as a more objective method for assessing surgical trainees. The composite score may be used to implement a standardized and feasible simulation-based mastery training program in video-assisted thoracoscopic surgery lobectomy. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu