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Competency assessment tool for laparoscopic suturing: development and reliability evaluation.

Wouter M IJgosse1,2, Erik Leijte3, Sandeep Ganni4,5,6

  • 1Department of Surgery, Radboud University Medical Center, Geert Grooteplein zuid 10, 6525 GA, Nijmegen, Gelderland, The Netherlands. Wouter.IJgosse@radboudumc.nl.

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|August 28, 2019
PubMed
Summary
This summary is machine-generated.

A new laparoscopic suturing competency assessment tool (LS-CAT) was developed and validated. This objective tool demonstrates excellent reliability for assessing surgical skills in laparoscopic suturing and knot tying.

Keywords:
EvaluationLaparoscopic suturingObjective assessmentSimulationTraining

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Area of Science:

  • Surgical Education
  • Minimally Invasive Surgery
  • Medical Simulation

Background:

  • Laparoscopic suturing is a complex surgical skill requiring extensive training.
  • Current assessment methods lack objectivity and specificity for laparoscopic suturing and knot tying.
  • There is a need for a reliable tool to guide training and monitor performance in these skills.

Purpose of the Study:

  • To develop a laparoscopic suturing competency assessment tool (LS-CAT).
  • To assess the inter-observer reliability of the developed LS-CAT.
  • To evaluate the tool's ability to discriminate between different levels of surgical expertise.

Main Methods:

  • A bespoke LS-CAT was developed using a mixed-methods approach and expert Delphi consultation.
  • Simulated laparoscopic suturing tasks, including two surgical knots, were performed by subjects with varying expertise.
  • Video recordings of performances were anonymized and assessed by two blinded expert surgeons using the LS-CAT.

Main Results:

  • The LS-CAT demonstrated excellent inter-observer reliability across multiple tasks, with Cohen's Kappa values indicating good to excellent agreement (0.75-0.87).
  • Subjects showed significant improvement in LS-CAT performance scores from their initial attempts to the end of their learning curve (p < 0.001).
  • The tool effectively discriminated between different levels of laparoscopic surgical experience.

Conclusions:

  • The LS-CAT is a novel, reliable grading matrix for laparoscopic suturing.
  • The tool exhibits excellent inter-rater reliability and can differentiate between varying levels of surgical experience.
  • The LS-CAT holds potential for objective assessment and standardized training in laparoscopic suturing skills.