Evaluation of advanced laparoscopic skills tasks for validity evidence

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Skills Assessment

Background:

• Fundamentals of Laparoscopic Surgery (FLS) sets a minimum standard, but advanced proficiency standards are needed for surgical training.
• The study evaluated the acceptance and discriminative ability of novel advanced laparoscopic surgery (ALS) skills.
• ALS aims to represent a more advanced proficiency standard beyond FLS.

Purpose of the Study:

• To evaluate the acceptance and discriminative ability of advanced laparoscopic surgery (ALS) tasks.
• To establish a more advanced proficiency standard for laparoscopic surgery training.
• To assess the relationship between surgeon experience and performance on ALS tasks.

Main Methods:

• Employed qualitative and quantitative analyses.
• Compared expert, intermediate, and novice surgeons on FLS and ALS tasks using composite scores (time and errors).
• Conducted thematic review of expert feedback on ALS tasks.

Main Results:

• No overall difference in FLS/ALS performance across experience levels in the entire cohort.
• In the general/MIS/bariatric/colorectal (GMBC) subgroup, experts and intermediates outperformed novices on ALS tasks.
• GMBC subgroup performed significantly better than other specialties on both FLS and ALS tasks; experts found ALS more realistic and clinically relevant.

Conclusions:

• Evidence of validity for ALS tasks in relation to skill level was shown for GMBC surgeons.
• This study is a foundational step for developing an advanced laparoscopic skills curriculum.
• Specialty-specific advanced skills curricula are necessary due to surgical specialization.