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Camera navigation and cannulation: validity evidence for new educational tasks to complement the Fundamentals of Laparoscopic Surgery Program

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Abstract

Background

Experts identified camera navigation and cannulation as important skills that are not assessed by the Fundamentals of Laparoscopic Surgery (FLS) hands-on examination. The purpose of this study was to create metrics for and evaluate the validity for two new tasks: camera navigation (N) and cannulation (C), and to explore the potential value of adding these tasks to the FLS program.

Methods

Participants were assessed by two raters during performance of N and C in addition to the five standard FLS tasks. They also completed a questionnaire regarding the educational value of the new tasks. Validity evidence was assessed by comparing performance between Novice (PGY 1 and 2) and Experienced (PGY 3 and higher) participants, and by correlating new task scores with standard FLS scores. The ability to predict level of training using scores was evaluated by regression analysis.

Results

Sixty subjects participated from five North American centers. Inter-rater reliabilities for both tasks were 0.99. Novice and Experienced participants scored 74 ± 17.8 versus 85 ± 8.3 (p < 0.01) and 21 ± 17.3 versus 39 ± 20.1 (p < 0.01) on N and C tasks, respectively. Correlations with total FLS scores for N and C were 0.39 and 0.53, respectively. Prediction of training level using the combination of all seven tasks was 52.6 % (R 2 = 0.526, p < 0.01), adding an additional 2.2 % to the five FLS tasks. Of 55 participants with laparoscopic experience, 51 % reported N to be similar in difficulty to reality. Of 28 participants who perform intraoperative cholangiograms, 43 % found C to be more difficult than reality. Most (70 %) participants thought the new tasks added value to FLS.

Conclusions

This study provides preliminary validity evidence for the metrics of these new tasks. The value of adding these tasks to the FLS manual skills assessment is marginal in terms of predicting level of training.

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Acknowledgments

The authors would like to acknowledge Sarah Colon, Carla Bryant, and Inga Brissman from SAGES for their unrelenting support, phenomenal expertise, organizational, and administrative skills. In addition, we would also like to acknowledge Robin Hayward, Deborah Hogg, Tricia Foster, Anne M Quirk, Janet Adeletti, and all of the members of the FLS task force for their hard work and contributions. We would also like to thank psychometrician Kaaren Hoffman, PhD, of the University of Southern California, Division of Medical Education, Emerita status for her expertise in analyzing and interpreting the data. Finally, without the generosity of all of the participants, this study and this program would not have been possible.

Disclosures

Drs. Yusuke Watanabe, E. Matt Ritter, James R. Korndorffer Jr., Daniel J. Scott, Allan Okrainec, and Mary T. O’Donnell; Elif Bilgic and Pepa A. Kaneva have no conflicts of interest or financial ties to disclose. Dr. Liane S. Feldman is a consultant for Covidien and received an investigator-initiated research grant from Ethicon. Drs. Melina C. Vassiliou and Gerald M. Fried have received unrestricted educational grants from Covidien. Dr. Steven D. Schwaitzberg has served on advisory panels and has received an honorarium from Stryker and Olympus. He has served on advisory panels for Neatstitch and Surgiquest. He has also received a Grant from Ethicon.

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Authors and Affiliations

  1. Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, Room L9-313, Montreal, QC, H3G 1A4, Canada

    Yusuke Watanabe, Pepa A. Kaneva, Liane S. Feldman, Gerald M. Fried & Melina C. Vassiliou

  2. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada

    Yusuke Watanabe, Elif Bilgic, Pepa A. Kaneva, Liane S. Feldman, Gerald M. Fried & Melina C. Vassiliou

  3. Department of Surgery, Uniformed Services University/Walter Reed Medical Simulation Center, Bethesda, MD, USA

    E. Matt Ritter & Mary T. O’Donnell

  4. Department of Surgery, Cambridge Health Alliance, Cambridge, MA, USA

    Steven D. Schwaitzberg

  5. Department of Surgery, Tulane University Health Sciences Center, New Orleans, LA, USA

    James R. Korndorffer Jr.

  6. Southwestern Center for Minimally Invasive Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Daniel J. Scott

  7. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Allan Okrainec

Authors
  1. Yusuke Watanabe
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  2. E. Matt Ritter
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  4. James R. Korndorffer Jr.
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  5. Daniel J. Scott
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  6. Allan Okrainec
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  7. Elif Bilgic
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  8. Pepa A. Kaneva
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  9. Mary T. O’Donnell
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  10. Liane S. Feldman
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  11. Gerald M. Fried
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  12. Melina C. Vassiliou
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Corresponding author

Correspondence to Melina C. Vassiliou.

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Watanabe, Y., Matt Ritter, E., Schwaitzberg, S.D. et al. Camera navigation and cannulation: validity evidence for new educational tasks to complement the Fundamentals of Laparoscopic Surgery Program. Surg Endosc 29, 552–557 (2015). https://doi.org/10.1007/s00464-014-3721-5

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  • DOI: https://doi.org/10.1007/s00464-014-3721-5

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