Validity and reliability of the robotic Objective Structured Assessment of Technical Skills

Abstract

Objective: Objective Structured Assessments of Technical Skills have been developed to measure the skill of surgical trainees. Our aim was to develop an Objective Structured Assessments of Technical Skills specifically for trainees learning robotic surgery.

Methods: This is a multiinstitutional study conducted in eight academic training programs. We created an assessment form to evaluate robotic surgical skill through five inanimate exercises. Gynecology, general surgery, and urology residents, Fellows, and faculty completed five robotic exercises on a standard training model. Study sessions were recorded and randomly assigned to three blinded judges who scored performance using the assessment form. Construct validity was evaluated by comparing scores between participants with different levels of surgical experience; interrater and intrarater reliability were also assessed.

Results: We evaluated 83 residents, nine Fellows, and 13 faculty totaling 105 participants; 88 (84%) were from gynecology. Our assessment form demonstrated construct validity with faculty and Fellows performing significantly better than residents (mean scores 89±8 faculty, 74±17 Fellows, 59±22 residents; P<.01). In addition, participants with more robotic console experience scored significantly higher than those with fewer prior console surgeries (P<.01). Robotic Objective Structured Assessments of Technical Skills demonstrated good interrater reliability across all five drills (mean Cronbach's α 0.79±0.02). Intrarater reliability was also high (mean Spearman's correlation 0.91±0.11).

Conclusion: We developed a valid and reliable assessment form for robotic surgical skill. When paired with standardized robotic skill drills, this form may be useful to distinguish between levels of trainee performance.

Level of evidence: II.

Fig 1

Images of five robotic skill drills: a) Tower transfer – transfer of rubber band from inner small towers to outer graduated height towers; b) Roller coaster – manipulate rubber band around wire loop; c) Big dipper – place needle into sponge in various arcs through pre-specified dot pattern; d) Train tracks – place a running suture with needle entering and exiting through dots; e) Figure of eight – place a figure of eight stitch with needle entering and exiting through dots followed by a square knot. Detailed information regarding drills and set-up is available at: www.robotictraining.org.