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Objective structured assessment of technical skill in temporal bone dissection: validation of a novel tool

Published online by Cambridge University Press:  12 May 2021

M Stavrakas*
Affiliation:
ENT Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
G Menexes
Affiliation:
Department of Field Crops and Ecology, Faculty of Agriculture, Forestry and Natural Environment, School of Agriculture, Aristotle University of Thessaloniki, Thessaloniki, Greece
S Triaridis
Affiliation:
ENT Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
P Bamidis
Affiliation:
Laboratory of Medical Physics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
J Constantinidis
Affiliation:
ENT Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
P D Karkos
Affiliation:
ENT Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
*
Author for correspondence: Dr Marios Stavrakas, ENT Department, Αristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki Kiriakidi 1, Thessaloniki 546 21, Greece E-mail: mstavrakas@doctors.org.uk

Abstract

Objective

This study developed an assessment tool that was based on the objective structured assessment for technical skills principles, to be used for evaluation of surgical skills in cortical mastoidectomy. The objective structured assessment of technical skill is a well-established tool for evaluation of surgical ability. This study also aimed to identify the best material and printing method to make a three-dimensional printed temporal bone model.

Methods

Twenty-four otolaryngologists in training were asked to perform a cortical mastoidectomy on a three-dimensional printed temporal bone (selective laser sintering resin). They were scored according to the objective structured assessment of technical skill in temporal bone dissection tool developed in this study and an already validated global rating scale.

Results

Two external assessors scored the candidates, and it was concluded that the objective structured assessment of technical skill in temporal bone dissection tool demonstrated some main aspects of validity and reliability that can be used in training and performance evaluation of technical skills in mastoid surgery.

Conclusion

Apart from validating the new tool for temporal bone dissection training, the study showed that evolving three-dimensional printing technologies is of high value in simulation training with several advantages over traditional teaching methods.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr M Stavrakas takes responsibility for the integrity of the content of the paper

References

Bismuth, J, Donovan, MA, O'Malley, MK, El Sayed, HF, Naoum, JJ, Peden, EK et al. Incorporating simulation in vascular surgery education. J Vasc Surg 2010;52:1072–80CrossRefGoogle ScholarPubMed
Satava, RM. The revolution in medical education-the role of simulation. J Grad Med Educ 2009;1:172–5CrossRefGoogle ScholarPubMed
Pandey, VA, Black, SA, Lazaris, AM, Allenberg, JR, Eckstein, HH, Hagmüller, GW et al. Do workshops improve the technical skill of vascular surgical trainees? Eur J Vasc Endovasc Surg 2005;30:441–7CrossRefGoogle Scholar
Musbahi, O, Aydin, A, Al Omran, Y, Skilbeck, CJ, Ahmed, K. Current status of simulation in otolaryngology: a systematic review. J Surg Educ 2017;74:203–15CrossRefGoogle ScholarPubMed
Fitzgerald, JEF, Caesar, BC. The European working time directive: a practical review for surgical trainees. Int J Surg 2012;10:399403CrossRefGoogle ScholarPubMed
Yule, S, Parker, SH, Wilkinson, J, McKinley, A, MacDonald, J, Neill, A et al. Coaching non-technical skills improves surgical residents’ performance in a simulated operating room. J Surg Educ 2015;72:1124–30CrossRefGoogle Scholar
Martin, JA, Regehr, G, Reznick, R, Macrae, H, Murnaghan, J, Hutchison, C et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 1997;84:273–8Google ScholarPubMed
Arnoldner, C, Lin, VYW, Chen, JM. Cortical mastoidectomy. In: Manual of Otologic Surgery. Vienna: Springer, 2015;513Google Scholar
Francis, HW, Masood, H, Laeeq, K, Bhatti, NI. Defining milestones toward competency in mastoidectomy using a skills assessment paradigm. Laryngoscope 2010;120:1417–21CrossRefGoogle ScholarPubMed
Cohen, J. Statistical Power Analysis for the Behavioral Sciences, 2nd edn. New Jersey: Lawrence Erlbaum Associates, 1988;13Google Scholar
Faul, F, Erdfelder, E, Lang, A-G, Buchner, A. G* Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175–91CrossRefGoogle ScholarPubMed
Faul, F, Erdfelder, E, Buchner, A, Lang, A-G. Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009;41:1149–60CrossRefGoogle Scholar
Hopmans, CJ, den Hoed, PT, van der Laan, L, van der Harst, E, van der Elst, M, Mannaerts, GHH et al. 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 2014;156:1078–88CrossRefGoogle ScholarPubMed
Chang, OH, King, LP, Modest, AM, Hur, H-C. Developing an objective structured assessment of technical skills for laparoscopic suturing and intracorporeal knot tying. J Surg Educ 2016;73:258–63CrossRefGoogle ScholarPubMed
Siddiqui, NY, Stepp, KJ, Lasch, SJ, Mangel, JM, Wu, JM. Objective structured assessment of technical skills for repair of fourth-degree perineal lacerations. Am J Obstet Gynecol 2008;199:676CrossRefGoogle ScholarPubMed
Siddiqui, NY, Galloway, ML, Geller, EJ, Green, IC, Hur, H-C, Langston, K et al. Validity and reliability of the robotic objective structured assessment of technical skills. Obstet Gynecol 2014;123:1193CrossRefGoogle ScholarPubMed
Schlager, A, Ahlqvist, K, Rasmussen-Barr, E, Bjelland, EK, Pingel, R, Olsson, C et al. Inter-and intra-rater reliability for measurement of range of motion in joints included in three hypermobility assessment methods. BMC Musculoskelet Disord 2018;19:376CrossRefGoogle ScholarPubMed
Jokinen, E, Mikkola, TS, Härkki, P. Simulator training and residents' first laparoscopic hysterectomy: a randomized controlled trial. Surg Endosc 2020;34:4874–82CrossRefGoogle ScholarPubMed
Rezniczek, GA, Severin, S, Hilal, Z, Dogan, A, Krentel, H, Buerkle, B et al. Surgical performance of large loop excision of the transformation zone in a training model: a prospective cohort study. Medicine (Baltimore) 2017;96:7026CrossRefGoogle Scholar
Reznick, R, Regehr, G, MacRae, H, Martin, J, McCulloch, W. Testing technical skill via an innovative “bench station” examination. Am J Surg 1997;173:226–30CrossRefGoogle Scholar
Nunnally, JC. Psychometric Theory, 3rd edn. New York: Tata McGraw-Hill Education, 1994Google Scholar
Spector, PE. Summated Rating Scale Construction: An Introduction. Newbury Park, CA: Sage, 1992CrossRefGoogle Scholar
Mehta, CR. SPSS Exact Tests 7.0 for Windows. Chicago: SPSS Inc, 1996Google Scholar
Mehta, CR, Patel, NR. Exact permutational inference for categorical and nonparametric data. Stat Strateg Small Sample Res. 1999;129Google Scholar
Landis, JR, Koch, GG. The measurement of observer agreement for categorical data. Biometrics 1977;33:159–74CrossRefGoogle ScholarPubMed
Crafts, TD, Ellsperman, SE, Wannemuehler, TJ, Bellicchi, TD, Shipchandler, TZ, Mantravadi, A V. Three-dimensional printing and its applications in otorhinolaryngology--head and neck surgery. Otolaryngol Neck Surg 2017;156:9991010CrossRefGoogle ScholarPubMed
Gross, BC, Erkal, JL, Lockwood, SY, Chen, C, Spence, DM. Evaluation of 3D printing and its potential impact on biotechnology and the chemical sciences. Anal Chem 2014;86:3240–53CrossRefGoogle ScholarPubMed
Canzi, P, Magnetto, M, Marconi, S, Morbini, P, Mauramati, S, Aprile, F et al. New frontiers and emerging applications of 3D printing in ENT surgery: a systematic review of the literature. Acta Otorhinolaryngol Ital 2018;38:286303Google ScholarPubMed
Yushkevich, PA, Piven, J, Hazlett, HC, Smith, RG, Ho, S, Gee, JC et al. User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. Neuroimage 2006;31:1116–28CrossRefGoogle ScholarPubMed
Cohen, J, Reyes, SA. Creation of a 3D printed temporal bone model from clinical CT data. Am J Otolaryngol 2015;36:619–24CrossRefGoogle ScholarPubMed
Da Cruz, MJ, Francis, HW. Face and content validation of a novel three-dimensional printed temporal bone for surgical skills development. J Laryngol Otol 2015;129:S23–9CrossRefGoogle ScholarPubMed
Hochman, JB, Rhodes, C, Wong, D, Kraut, J, Pisa, J, Unger, B. Comparison of cadaveric and isomorphic three-dimensional printed models in temporal bone education. Laryngoscope 2015;125:2353–7CrossRefGoogle ScholarPubMed
Mowry, SE, Jammal, H, Myer, C IV, Solares, CA, Weinberger, P. A novel temporal bone simulation model using 3D printing techniques. Otol Neurotol 2015;36:1562–5CrossRefGoogle ScholarPubMed
Rose, AS, Webster, CE, Harrysson, OLA, Formeister, EJ, Rawal, RB, Iseli, CE. Preoperative simulation of pediatric mastoid surgery with 3D-printed temporal bone models. Int J Pediatr Otorhinolaryngol 2015;79:740–4CrossRefGoogle Scholar
Hochman, JB, Kraut, J, Kazmerik, K, Unger, BJ. Generation of a 3D printed temporal bone model with internal fidelity and validation of the mechanical construct. Otolaryngol Neck Surg 2014;150:448–54CrossRefGoogle ScholarPubMed
Grunert, R, Strauss, G, Moeckel, H, Hofer, M, Poessneck, A, Fickweiler, U et al. ElePhant--an anatomical electronic phantom as simulation--system for otologic surgery. Conf Proc IEEE Eng Med Biol Soc 2006;4408–11CrossRefGoogle ScholarPubMed