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Título

NEW SCORING METHOD OF A ROBOTIC SUTURE ASSESSMENT TOOL

Resumo

Introduction: Robotic surgeons' competency evaluations are often performed based on case records that only measure the operational experience and use subjective criteria with low reliability. Objective assessments tools such as checklists and global rating scales are required to adequately assess robotic surgical skills and enable learning feedback. The choice of assessment tool depends on the purpose and especially the context. Although most robotic surgical procedures require suture there are only one published study on suture evaluation in robot-assisted surgery (RAS).
Objective: To develop a new scoring method for suture assessment in robotic surgery.
Methods: This prospective study aimed to construct the Suture Checklist of Objective Robotic Evaluation (SCORE) tool by a panel of experts in RAS and medical education, based on two validated assessments: Guni’ Suture Checklist (SC) and Global Evaluative Assessment of Robotic Surgery (GEARS). Then, a validation study was carried out using the Messick’s framework. A total of 15 participants were divided into trainee and expert groups and practiced a suture task in an ex vivo simulation model and in real-world theater on the robotic platform. The videos of suture tasks were evaluated by blinded raters using SC, GEARS and SCORE. The tools were correlated and the performances were compared using STATA®.
Results: The assessments using objective evaluations tools allowed a clear discrimination between experts and trainees (p<0,005) and the results were consistent from one measurement to another (Cronbach’s Alpha Coefficient = 0.8410). The Pearson’s correlation coefficient (r) between GEARS and SCORE was 0.9840, with a CI of 95% between 0.95 and 0.99 (p< 0.0001); and r between SC and SCORE was 0.5839, with a CI of 95% between 0.10 and 0.84 (p= 0.0222). The Intraclass Correlation Coefficient between the judges in SCORE was 0.91, (p< 0.0001) demonstrating the excellent replicability of this test.
Conclusions: The SCORE tool is an objective and structured assessment tool that can cover all steps in the context of a robotic suture and provides feedback to trainees about their performances.

Palavras Chave ( separado por ; )

Robotic surgery; Assessment; Simulation training; Education; Suture techniques.