Assessment of Technical Skills in Axillary Lymph Node Dissection

Area of Science:

• Surgical Simulation
• Medical Education Technology
• Surgical Skills Assessment

Background:

• Reduced clinical exposure to axillary lymph node dissection (ALND) has decreased resident confidence and proficiency.
• A need exists for safe and effective training methods to maintain surgical competency.

Purpose of the Study:

• To design and validate a simulator for practicing and assessing axillary lymph node dissection (ALND).
• To evaluate the face, content, and construct validity of the ALND simulator.

Main Methods:

• A cross-sectional, multicenter observational study involving 30 surgeons of varying experience levels.
• Surgeons performed simulated ALND procedures, followed by face and content validity assessments.
• Procedures were retrospectively evaluated using video-based and end-product assessment tools.

Main Results:

• Statistically significant differences in operative performance were observed between surgeon groups (P < 0.001).
• The simulator demonstrated good anatomical and procedural realism, with median scores above 7.
• While overall quality and lymph node yield differed, specific adverse events like nerve injury were not distinguished by operator grade.

Conclusions:

• The ALND simulator possesses construct validity, as evidenced by video-based analysis.
• This simulation serves as a valuable adjunct for technical skills training and formative assessments.
• It addresses the challenge of reduced ALND exposure in surgical education.