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Validation of a simulator for oncoplastic breast conserving surgery
Laith O K Alghazawi1, Stella Mavroveli2, Eleni Anastasiou2
1Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Breast Unit, Imperial College Healthcare NHS Trust, London, United Kingdom.
Summary
A new simulator for Therapeutic Mammoplasty (TM) was developed to train and assess oncoplastic skills. This tool effectively differentiates expert surgeons from novices, validating its use in surgical education.
Area of Science:
- Surgical Oncology
- Medical Simulation
- Surgical Education
Background:
- Therapeutic Mammoplasty (TM) is a key procedure for large tumor-to-breast volume ratios.
- There is a need for validated simulation tools for oncoplastic skill acquisition and assessment.
- Current TM training lacks standardized simulation methods.
Purpose of the Study:
- To design, develop, and validate a synthetic simulator for Therapeutic Mammoplasty (TM).
- To create a tool for specialist surgical training and assessment of oncoplastic skills.
- To evaluate the simulator's ability to differentiate surgical expertise.
Main Methods:
- A prospective, observational study involving breast surgeons and designers to create a TM simulator.
- Development of a Competency Assessment Tool (CAT) using a modified Delphi approach.
- Simulated vertical scar TM procedures were videotaped, rated by experts using CAT, and specimen analysis (weight, volume, margin uniformity) was performed.
Main Results:
- Thirty surgeons (consultants, senior registrars, junior registrars) participated.
- Video-based ratings and CAT scores were significantly higher for consultants compared to registrars (p < 0.05).
- Consultants achieved greater specimen weight, volume, and resection uniformity, indicating higher proficiency.
Conclusions:
- A novel synthetic simulator for practicing and assessing Therapeutic Mammoplasty (TM) skills has been developed.
- The simulator, through video-based ratings and specimen analysis, demonstrated construct validity by differentiating expert from novice surgeons.
- This simulator represents a valuable tool for enhancing oncoplastic surgical training and competency assessment.
