A novel assessment tool for evaluating competence in video-assisted thoracoscopic surgery lobectomy
- 114 Downloads
Specific assessment tools can accelerate trainees’ learning through structured feedback and ensure that trainees attain the knowledge and skills required to practice as competent, independent surgeons (competency-based surgical education). The objective was to develop an assessment tool for video-assisted thoracoscopic surgery (VATS) lobectomy by achieving consensus within an international group of VATS experts.
The Delphi method was used as a structured process for collecting and distilling knowledge from a group of internationally recognized VATS experts. Opinions were obtained in an iterative process involving answering repeated rounds of questionnaires. Responses to one round were summarized and integrated into the next round of questionnaires until consensus was reached.
Thirty-one VATS experts were included and four Delphi rounds were conducted. The response rate for each round were 68.9% (31/45), 100% (31/31), 96.8% (30/31), and 93.3% (28/30) for the final round where consensus was reached. The first Delphi round contained 44 items and the final VATS lobectomy Assessment Tool (VATSAT) comprised eight items with rating anchors: (1) localization of tumor and other pathological tissue, (2) dissection of the hilum and veins, (3) dissection of the arteries, (4) dissection of the bronchus, (5) dissection of lymph nodes, (6) retrieval of lobe in bag, (7) respect for tissue and structures, and (8) technical skills in general.
A novel and dedicated assessment tool for VATS lobectomy was developed based on VATS experts’ consensus. The VATSAT can support the learning of VATS lobectomy by providing structured feedback and help supervisors make the important decision of when trainees have acquired VATS lobectomy competencies for independent performance.
KeywordsAssessment tool VATS video-assisted thoracoscopic surgery Lobectomy Thoracic surgical training Competency-based education
VATS lobectomy experts were kindly asked to participate as part of the expert panel, and could decline at any phase in the study. At any time, participants could withdraw their consent for participation and their data would be deleted. All data were kept strictly confidential. The questionnaires from each expert were not discussed with colleagues or other individuals. The experts were told that the answers they gave in the questionnaires were anonymous for all except the main author who was handling the data via email and Survey Monkey, but that they would be acknowledged by name in the published paper if they wished to.
VATS lobectomy assessment tool expert panel: Baste JM, Bodner J, Cao C, Casali G, D’amico T, De Ryck F, Decaluwe HMA, Decker G, Dunning J, Gossot D, Kohno T, Leschber G, Liptay MJ, Loscertales J, McKenna RJ, Mitchell JD, Oosterhuis JW, Piwkowski CT, Schmid T, Schneiter D, Shackcloth M, Siebenga J, Sihoe A, Sokolow Y, Solaini L, Wright GM, Yan TD.
The salary of Katrine Jensen was partly funded by a grant from The Danish Cancer Society (Kræftens Bekæmpelse, Denmark).
Compliance with ethical standards
Henrik Jessen Hansen and René Horsleben Petersen are at the speaker’s bureau for Covidien. Jesper Holst Pedersen, William Walker, and Lars Konge have no conflicts of interest or financial ties to disclose.
No samples from humans were used in the study and no drugs were administered; hence, this study needed no approval from The Danish National Committee on Biomedical Research Ethics.
- 1.Falcoz PE, Puyraveau M, Thomas PA, Decaluwe H, Hurtgen M, Petersen RH, Hansen H, Brunelli A (2016) Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer: a propensity-matched analysis of outcome from the European Society of Thoracic Surgeon database. Eur J Cardiothorac Surg 49:602–609. https://doi.org/10.1093/ejcts/ezv154 CrossRefPubMedGoogle Scholar
- 2.Laursen L, Petersen RH, Hansen HJ, Jensen TK, Ravn J, Konge L (2016) Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy. Eur J Cardiothorac Surg 49:870–875. https://doi.org/10.1093/ejcts/ezv205 CrossRefPubMedGoogle Scholar
- 3.Whitson BA, Groth SS, Duval SJ, Swanson SJ, Maddaus MA (2008) Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg 86:2008–2018. https://doi.org/10.1016/j.athoracsur.2008.07.009 CrossRefPubMedGoogle Scholar
- 8.Carrott PW, Jones DR (2013) Teaching video-assisted thoracic surgery (VATS) lobectomy. J Thorac Dis. https://doi.org/10.3978/j.issn.2072-1439.2013.07.31 PubMedPubMedCentralGoogle Scholar
- 19.Hopmans CJ, den Hoed PT, van der Laan L, van der Harst E, van der Elst M, Mannaerts GHH, Dawson I, Timman R, Wijnhoven BPL, IJzermans JNM (2014) Assessment of surgery residents’ operative skills in the operating theater using a modified objective structured assessment of technical skills (OSATS): a prospective multicenter study. Surgery 156:1078–1088. https://doi.org/10.1016/j.surg.2014.04.052 CrossRefPubMedGoogle Scholar
- 23.Day J, Bobeva M (2005) A generic toolkit for the successful management of delphi studies. Electron J Bus Res Methods 3:103–116Google Scholar
- 24.Jensen K, Bjerrum F, Hansen HJ, Petersen RH, Pedersen JH, Konge L (2015) A new possibility in thoracoscopic virtual reality simulation training: development and testing of a novel virtual reality simulator for video-assisted thoracoscopic surgery lobectomy. Interact Cardiovasc Thorac Surg 21:420–426. https://doi.org/10.1093/icvts/ivv183 CrossRefPubMedGoogle Scholar
- 26.Savran MM, Hansen HJ, Petersen RH, Walker W, Schmid T, Bojsen SR, Konge L (2015) Development and validation of a theoretical test of proficiency for video-assisted thoracoscopic surgery (VATS) lobectomy. Surg Endosc 29:2598–2604. https://doi.org/10.1007/s00464-014-3975-y CrossRefPubMedGoogle Scholar
- 29.Miskovic D, Ni M, Wyles SM, Kennedy RH, Francis NK, Parvaiz A, Cunningham C, Rockall TA, Gudgeon AM, Coleman MG, Hanna GB (2013) Is competency assessment at the specialist level achievable? A study for the national training programme in laparoscopic colorectal surgery in England. Ann Surg 257:476–482. https://doi.org/10.1097/SLA.0b013e318275b72a CrossRefPubMedGoogle Scholar