Performance in the Fundamentals of Laparoscopic Surgery: Does it reflect global rating scales in the Objective Structured Assessment of Technical Skills in porcine laparoscopic surgery?
aYong Loo Lin School of Medicine, Department of Surgery, National University of Singapore, Singapore bS.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China cDepartment of Urology, Juntendo University Graduate School of Medicine, Tokyo, Japan dDepartment of Urology, National University Hospital, Singapore eDepartment of Urology, Beijing United Family Hospital, Beijing, China fDepartment of Surgery, University of Malaya Specialist Centre, Kuala Lumpur, Malaysia gDivision of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong hDepartment of Urology, Ramathibodi Hospital, Mahidol University, Salaya, Thailand iDepartment of Urology, Beijing Hospital, Beijing, China jDepartment of Urology, Chiangmai Ram Hospital, Chiang Mai, Thailand kInternational Urology, Fertility & Gynaecology Centre, Singapore
Objective: To correlate the utility of the Fundamentals of Laparoscopic Surgery (FLS) manual skills program with the Objective Structured Assessment of Technical Skills (OSATS) global rating scale in evaluating operative performance.
Methods: The Asian Urological Surgery Training and Educational Group (AUSTEG) Laparoscopic Upper Tract Surgery Course implemented and validated the FLS program for its usage in laparoscopic surgical training. Delegates’ basic laparoscopic skills were assessed using three different training models (peg transfer, precision cutting, and intra-corporeal suturing). They also performed live porcine laparoscopic surgery at the same workshop. Live surgery skills were assessed by blinded faculty using the OSATS rating scale.
Results: From March 2016 to March 2019, a total of 81 certified urologists participated in the course, with a median of 5 years of post-residency experience. Although differences in task time did not reach statistical significance, those with more surgical experience were visibly faster at completing the peg transfer and intra-corporeal suturing FLS tasks. However, they took longer to complete the precision cutting task than participants with less experience. Overall OSATS scores correlated weakly with all three FLS tasks (peg transfer time: r=−0.331, r2=0.110; precision cutting time: r=−0.240, r2=0.058; suturing with intra-corporeal knot time: r=−0.451, r2=0.203).
Conclusion: FLS task parameters did not correlate strongly with OSATS globing rating scale performance. Although FLS task models demonstrated strong validity, it is important to assimilate the inconsistencies when benchmarking technical proficiency against real-life operative competence, as evaluated by FLS and OSATS, respectively.
. [J]. Asian Journal of Urology, 2024, 11(3): 443-449.
Ho Yee Tiong, Wei Zheng So, Jeremy Yuen-Chun Teoh, Shuji Isotani, Gang Zhu, Teng Aik Ong, Eddie Shu-Yin Chan, Peggy Sau-Kwan Chu, Kittinut Kijvikai, Ming Liu, Bannakji Lojanapiwat, Michael Wong, Anthony Chi-Fai Ng. Performance in the Fundamentals of Laparoscopic Surgery: Does it reflect global rating scales in the Objective Structured Assessment of Technical Skills in porcine laparoscopic surgery?. Asian Journal of Urology, 2024, 11(3): 443-449.
Have performed at least one LN in the past 6 months, n (%)
0.547
Yes
51 (94.4)
27 (100)
No
3 (5.6)
0 (0)
Tasks
Performance time, s
p-Value
≤10 LNsa (n=54)
>10 LNsb (n=27)
Peg transfer
148.8±52.4
138.4±56.7
0.200
Precision cutting
232.3±112.2
252.4±144.7
0.767
Intra-corporeal suturing
280.7±169.8
247.1±152.4
0.296
Component
OSATS evaluation scores
p-Value
≤10 LNsa (n=54)
>10 LNsb (n=27)
Respect of tissue
3.76±0.60
4.03±0.42
0.073
Time and motion
3.55±0.75
3.56±0.62
0.765
Instrument handling
3.66±0.69
3.77±0.56
0.617
Knowledge of instruments
4.02±0.54
4.06±0.58
0.491
Flow of operation
3.68±0.63
3.81±0.72
0.325
Use of assistant
3.69±0.61
3.84±0.62
0.246
Procedure knowledge
3.84±0.68
3.97±0.65
0.521
Overall
3.74±0.56
3.86±0.48
0.365
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