Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)

RAPN training usually takes place in-vivo and methods vary across countries/institutions. No common system exists to objectively assess trainee capacity to perform RAPN at predetermined performance levels prior to in-vivo practice. The identification of objective performance metrics for RAPN trainin...

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Autores: Farinha, Rui, Breda, Alberto|||0000-0002-7842-9048, Porter, James, Mottrie, Alexandre, Van Cleynenbreugel, Ben, Vander Sloten, Jozef, Mottaran, Angelo, Gallagher, Anthony G.
Formato: artículo
Fecha de publicación:2023
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:302809
Acesso em linha:https://ddd.uab.cat/record/302809
https://dx.doi.org/urn:doi:10.1007/s11701-023-01521-1
Access Level:acceso abierto
Palavra-chave:Construct validation
Metrics
Proficiency-based training
Renal cancer
Robot-assisted partial nephrectomy
Surgical training
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spelling Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)Farinha, RuiBreda, Alberto|||0000-0002-7842-9048Porter, JamesMottrie, AlexandreVan Cleynenbreugel, BenVander Sloten, JozefMottaran, AngeloGallagher, Anthony G.Construct validationMetricsProficiency-based trainingRenal cancerRobot-assisted partial nephrectomySurgical trainingRAPN training usually takes place in-vivo and methods vary across countries/institutions. No common system exists to objectively assess trainee capacity to perform RAPN at predetermined performance levels prior to in-vivo practice. The identification of objective performance metrics for RAPN training is a crucial starting point to improve training and surgical outcomes. The authors sought to examine the reliability, construct and discriminative validity of objective intraoperative performance metrics which best characterize the optimal and suboptimal performance of a reference approach for training novice RAPN surgeons. Seven Novice and 9 Experienced RAPN surgeons video recorded one or two independently performed RAPN procedures in the human. The videos were anonymized and two experienced urology surgeons were trained to reliably score RAPN performance, using previously developed metrics. The assessors were blinded to the performing surgeon, hospital and surgeon group. They independently scored surgeon RAPN performance. Novice and Experienced group performance scores were compared for procedure steps completed and errors made. Each group was divided at the median for Total Errors score, and subgroup scores (i.e., Novice HiErrs and LoErrs, Experienced HiErrs and LoErrs) were compared. The mean inter-rater reliability (IRR) for scoring was 0.95 (range 0.84-1). Compared with Novices, Experienced RAPN surgeons made 69% fewer procedural Total Errors. This difference was accentuated when the LoErr Expert RAPN surgeon's performance was compared with the HiErrs Novice RAPN surgeon's performance with an observed 170% fewer Total Errors. GEARS showed poor reliability (Mean IRR = 0.44; range 0.0-0.8), for scoring RAPN surgical performance. The RAPN procedure metrics reliably distinguish Novice and Experienced surgeon performances. They further differentiated performance levels within a group with similar experiences. Reliable and valid metrics will underpin quality-assured novice RAPN surgical training.Universitat Autònoma de Barcelona 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/302809https://dx.doi.org/urn:doi:10.1007/s11701-023-01521-1reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3028092026-06-06T12:50:31Z
dc.title.none.fl_str_mv Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)
title Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)
spellingShingle Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)
Farinha, Rui
Construct validation
Metrics
Proficiency-based training
Renal cancer
Robot-assisted partial nephrectomy
Surgical training
title_short Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)
title_full Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)
title_fullStr Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)
title_full_unstemmed Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)
title_sort Objective assessment of intraoperative skills for robot-assisted partial nephrectomy (RAPN)
dc.creator.none.fl_str_mv Farinha, Rui
Breda, Alberto|||0000-0002-7842-9048
Porter, James
Mottrie, Alexandre
Van Cleynenbreugel, Ben
Vander Sloten, Jozef
Mottaran, Angelo
Gallagher, Anthony G.
author Farinha, Rui
author_facet Farinha, Rui
Breda, Alberto|||0000-0002-7842-9048
Porter, James
Mottrie, Alexandre
Van Cleynenbreugel, Ben
Vander Sloten, Jozef
Mottaran, Angelo
Gallagher, Anthony G.
author_role author
author2 Breda, Alberto|||0000-0002-7842-9048
Porter, James
Mottrie, Alexandre
Van Cleynenbreugel, Ben
Vander Sloten, Jozef
Mottaran, Angelo
Gallagher, Anthony G.
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Construct validation
Metrics
Proficiency-based training
Renal cancer
Robot-assisted partial nephrectomy
Surgical training
topic Construct validation
Metrics
Proficiency-based training
Renal cancer
Robot-assisted partial nephrectomy
Surgical training
description RAPN training usually takes place in-vivo and methods vary across countries/institutions. No common system exists to objectively assess trainee capacity to perform RAPN at predetermined performance levels prior to in-vivo practice. The identification of objective performance metrics for RAPN training is a crucial starting point to improve training and surgical outcomes. The authors sought to examine the reliability, construct and discriminative validity of objective intraoperative performance metrics which best characterize the optimal and suboptimal performance of a reference approach for training novice RAPN surgeons. Seven Novice and 9 Experienced RAPN surgeons video recorded one or two independently performed RAPN procedures in the human. The videos were anonymized and two experienced urology surgeons were trained to reliably score RAPN performance, using previously developed metrics. The assessors were blinded to the performing surgeon, hospital and surgeon group. They independently scored surgeon RAPN performance. Novice and Experienced group performance scores were compared for procedure steps completed and errors made. Each group was divided at the median for Total Errors score, and subgroup scores (i.e., Novice HiErrs and LoErrs, Experienced HiErrs and LoErrs) were compared. The mean inter-rater reliability (IRR) for scoring was 0.95 (range 0.84-1). Compared with Novices, Experienced RAPN surgeons made 69% fewer procedural Total Errors. This difference was accentuated when the LoErr Expert RAPN surgeon's performance was compared with the HiErrs Novice RAPN surgeon's performance with an observed 170% fewer Total Errors. GEARS showed poor reliability (Mean IRR = 0.44; range 0.0-0.8), for scoring RAPN surgical performance. The RAPN procedure metrics reliably distinguish Novice and Experienced surgeon performances. They further differentiated performance levels within a group with similar experiences. Reliable and valid metrics will underpin quality-assured novice RAPN surgical training.
publishDate 2023
dc.date.none.fl_str_mv 2
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/302809
https://dx.doi.org/urn:doi:10.1007/s11701-023-01521-1
url https://ddd.uab.cat/record/302809
https://dx.doi.org/urn:doi:10.1007/s11701-023-01521-1
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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