A Video-Based Assessment Tool to Measure Intraoperative Laparoscopic Suturing Using a Modified Script Concordance...

Area of Science:

• Surgical Education and Assessment
• Minimally Invasive Surgery
• Medical Simulation

Background:

• Laparoscopic suturing (LS) is a complex surgical skill that is difficult to teach and assess.
• Current simulation and assessment platforms do not adequately model or measure the nuances of LS.
• The script concordance test (SCT) is a validated tool for assessing clinical reasoning.

Purpose of the Study:

• To provide evidence for the validity of a novel, video-based, online SCT for assessing laparoscopic suturing skills.
• To evaluate the effectiveness of the SCT in differentiating between surgeons with varying levels of LS experience.

Main Methods:

• A video-based online SCT was designed using cognitive task analysis and expert panelists, covering needle handling, tissue handling, knot tying, and operative ergonomics.
• The test was administered to 37 surgeons (18 experts, 19 novices).
• Validity was assessed by comparing scores between expert and novice groups, with internal consistency evaluated using Cronbach's alpha.

Main Results:

• The final test comprised 26 questions across four domains, demonstrating a reliability of 0.80 (Cronbach's alpha).
• Experts achieved a mean score of 72 ± 9%, significantly higher than novices at 63 ± 15% (p = 0.02).
• The average completion time for the test was 21 minutes.

Conclusions:

• This study provides validity evidence for a novel intraoperative LS assessment tool.
• The SCT demonstrates potential to capture clinical differences and surgeon preferences in laparoscopic suturing.
• The developed online SCT serves as a promising tool for evaluating laparoscopic suturing proficiency.