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Establishing validity evidence for device-assisted advanced laparoscopic suturing tasks using simulation

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Abstract

Background

Laparoscopic suturing (LS) is an essential technique required for a wide range of procedures, and it is one of the most challenging for surgical trainees to master. We designed and collected validity evidence for advanced LS tasks using an automated suturing device and evaluated the perceived educational value of the tasks.

Methods

This project was a multicentre prospective study involving McGill University, University of Toronto (UofT), and Louisiana State University (LSU) Health New Orleans. Novice (NS) and experienced (ES) surgeons performed suturing under tension (UT) and continuous suturing (CS) tasks. ES performed the tasks twice to establish proficiency benchmarks, and they were interviewed to develop formative feedback tools (FFT). Participants were assessed on completion time, error, Global Operative Assessment of Laparoscopic Skills (GOALS), and FFT. Data were analyzed using descriptive and inferential statistical methods.

Results

Twenty-seven participants (13 ES, 14 NS, median age 34 years; 85% male) completed the study. Eight were attending surgeons, 7 fellows, 4 PGY5, 5 PGY4, and 3 PGY3 (18 from McGill, 5 UofT, and 4 LSU). Comparing ES and NS, for UT task, ES had significantly greater task scores (570 [563–648] vs 323 [130–464], p value 0.00036) and GOALS scores (14 [13–16] vs 10 [8–12], p value 0.0038). Similarly, for CS, ES had significantly greater task scores (976 [959–1010] vs 785 [626–856], p value 0.00009) and GOALS scores (16 [12–17] vs 12.5 [8.25–15], p value 0.028). After FFTs were developed, comparing ES and NS, for both UT and CS tasks, ES had significantly greater FFT scores (UT 25 [24–26] vs 17 [14–20], p value 0.0016 and CS 30 [27–32] vs 22[17.2–25.8], p value 0.00061).

Conclusion

In conclusion, preliminary validity evidence was provided for the tasks. Once further validity evidence is established, incorporating the tasks into the training curricula could improve trainee skills and help to meet the need for better advanced suturing models.

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Funding

This study was funded by a Royal College of Physicians and Surgeons of Canada Medical Education Research Grant received by Drs Elif Bilgic and Melina C. Vassiliou.

Author information

Authors and Affiliations

  1. Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, QC, Canada

    Elif Bilgic & Gerald M. Fried

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

    Elif Bilgic, Saba Balvardi, Sofia Valanci, Pepa Kaneva, Mohammed Alabri, Katherine M. McKendy, Melina C. Vassiliou & Gerald M. Fried

  3. Temerty Advanced Surgical Education and Simulation Centre, University Health Network, Toronto, ON, Canada

    Allan Okrainec & Caterina Masino

  4. Division of General Surgery, University Health Network, Toronto, ON, Canada

    Allan Okrainec

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

    Allan Okrainec

  6. Department of Surgery, School of Medicine, LSU Health New Orleans, New Orleans, LA, USA

    John Paige

  7. Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan

    Yusuke Watanabe

  8. Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, L9.303, Montreal, QC, H3G 1A4, Canada

    Katherine M. McKendy, Melina C. Vassiliou & Gerald M. Fried

  9. Department of Pediatrics, McMaster University, Hamilton, Canada

    Elif Bilgic

  10. McMaster Education Research, Innovation and Theory (MERIT) Program, McMaster University, Hamilton, Canada

    Elif Bilgic

Authors
  1. Elif Bilgic
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  2. Allan Okrainec
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  3. John Paige
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  4. Saba Balvardi
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  5. Sofia Valanci
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  6. Caterina Masino
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  7. Pepa Kaneva
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  8. Mohammed Alabri
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  9. Katherine M. McKendy
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  10. Yusuke Watanabe
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  11. Melina C. Vassiliou
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  12. Gerald M. Fried
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Corresponding author

Correspondence to Gerald M. Fried.

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Disclosures

This study was funded by a Royal College of Physicians and Surgeons of Canada Medical Education Research Grant received by Drs Elif Bilgic and Melina C. Vassiliou. Dr Fried is a consultant to Theator. Dr Okrainec reports honoraria fees for speaking and teaching from Medtronic, Ethicon, and Merck. Dr John Paige, Dr Saba Balvardi, Dr Sofia Valanci, Caterina Masino, Pepa Kaneva, Dr Mohammed Alabri, Dr Katherine M. McKendy, and Dr Yusuke Watanabe have no competing interests to declare that are relevant to the content of this article.

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Bilgic, E., Okrainec, A., Paige, J. et al. Establishing validity evidence for device-assisted advanced laparoscopic suturing tasks using simulation. Surg Endosc 36, 9099–9105 (2022). https://doi.org/10.1007/s00464-022-09380-x

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  • DOI: https://doi.org/10.1007/s00464-022-09380-x

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