Surgical educationA global assessment tool for evaluation of intraoperative laparoscopic skills
Section snippets
Development of the tool
The first step in the development of GOALS was the identification of important aspects of technical skills unique to laparoscopy. This was done by watching videotapes of a variety of laparoscopic procedures and by conferring with expert laparoscopists. The tool was developed based on a Global Rating Scale (GRS) introduced by Reznick et al for open surgery [15].
Reliability
The internal consistency of GOALS was excellent for all 4 groups of raters (Cronbach’s alpha ranged from .91 to .93; Table 4). Each item correlated highly with the total score (correlations were all >.70), and internal consistency was not improved with deletion of any single item (data not shown).
The ICC for total GOALS score was highest for the 2 trained observers at .89 (95% CI.74 to .95). The inclusion of attending surgeons or participants decreased the ICCs only slightly to .82 (95% CI .67
Comments
Surgical simulators are convenient, flexible, and easier to standardize than their real-life counterparts. Simulators claiming to be effective in the acquisition and evaluation of laparoscopic skill are not lacking [7], [18]. For minimally invasive surgery, they range from mirrored boxes to costly virtual reality interfaces [7], [19], [20]. It is clear that practice on simulators improves performance on that simulator [21]. Studies have also shown that training on certain simulators correlates
Acknowledgments
This research was funded by Tyco Healthcare Canada and by a Medical Education Research Grant from the Royal College of Physicians and Surgeons of Canada.
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