Abstract:
OBJECTIVES:To develop, validate, and implement a competency assessment tool (CAT) for technical surgical performance in the context of a summative assessment process for the National Training Programme in Laparoscopic Colorectal Surgery (NTP). BACKGROUND:The NTP is an educational initiative by the National Cancer Action Team in England to safely increase the uptake of laparoscopic colorectal surgery. It is the first competency-based national educational initiative for specialist surgeons (consultants), and performance assessment is an integral part of the program. METHODS:Content validity was sought using expert opinion by semistructured interviews and the Delphi method. For validity and reliability studies, NTP apprentices and experts were asked to submit video-recorded cases. Construct validity was established between delegates who passed the assessment and those who failed. Concurrent validity was tested by comparing scores with error counts as identified by observational clinical human reliability analysis. A fully crossed design, using generalizability theory methods and D-studies, was used for reliability. FINDINGS:Interviews and the Delphi method revealed a list of characteristics for assessment. A hybrid structure combining task-specific and generic items was used to include important characteristics into the assessment format. Fifty-four cases were submitted. Overall reliability reached G(ACI) = 0.803 when using 2 cases and 2 assessors. Experts scored significantly better than apprentices (3.19 vs 2.60; P = 0.004), and apprentices who passed had better scores than those who failed (2.95 vs 2.28; P < 0.001). There was an inverse correlation between CAT scores and observational clinical human reliability analysis error counts (ρ = -0.520, P < 0.001). The combination of both methods reached overall sensitivity of 100%, specificity of 83.3%, a positive predictive value of 93.8%, and a negative predictive value of 100%. CONCLUSIONS:The CAT can reliably assess technical performance in laparoscopic colorectal surgery. The use of CATs to judge specialist technical performance before embarking on independent practice of new procedures is achievable on a national scale and can be adapted by other specialties.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Miskovic D,Ni M,Wyles SM,Kennedy RH,Francis NK,Parvaiz A,Cunningham C,Rockall TA,Gudgeon AM,Coleman MG,Hanna GB,National Training Programme in Laparoscopic Colorectal Surgery in England.doi
10.1097/SLA.0b013e318275b72asubject
Has Abstractpub_date
2013-03-01 00:00:00pages
476-82issue
3eissn
0003-4932issn
1528-1140pii
00000658-201303000-00016journal_volume
257pub_type
杂志文章abstract::Despite recommended preoperative preparation with alpha-adrenergic blockers, severe hemodynamic instability may occur during operations to resect pheochromocytoma. We combined the alpha-blocker phenoxybenzamine with the tyrosine hydroxylase inhibitor metyrosine in an attempt to better manage the hypertension of patien...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-199011000-00010
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the fate of patients who attempted to donate organs after circulatory death (DCD) using a standardized DCD protocol. BACKGROUND:Successful donation is not always possible after attempted DCD. METHODS:Data were collected for all DCD donors between 1/2011 and 9/201...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001298
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:We hypothesized that distinct sets of functional trajectories can be identified in the year before and after major surgery, with unique transition probabilities from pre to postsurgical functional trajectories, and that outcomes would be better among participants undergoing elective versus nonelective surger...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002659
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Roux-en-Y gastric bypass (RYGBP) and sleeve gastrectomy (SG) have been associated with a high remission rate of type 2 diabetes mellitus (T2DM). However, whether such remission is associated with full restoration of postprandial glucose profile and/or the potentially nonrestored glycemic profile is associate...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000586
更新日期:2015-02-01 00:00:00
abstract::Percutaneous transhepatic bile drainage was performed in 13 patients with obstructive jaundice, using a combination of the PTC technique and a Seldinger angiography catheter. In 11 cases, the outflow of bile through the catheter was satisfactory and complications were few. Since the risk of the procedure is low and it...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197701000-00018
更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000520
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The COVID-19 pandemic requires to conscientiously weigh "timely surgical intervention" for colorectal cancer against efforts to conserve hospital resources and protect patients and health care providers. SUMMARY BACKGROUND DATA:Professional societies provided ad-hoc guidance at the outset of the COVID-19 pan...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004029
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to use updated data and Bayesian methods to evaluate the effectiveness of hyperoxia to reduce surgical site infections (SSIs) and/or mortality in both colorectal and all surgery patients. Because few trials assessed potential harms of hyperoxia, hazards were not included. BACKGRO...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0b013e31826cc8da
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To compare outcomes for patients with hepatocellular carcinoma (HCC) treated with either liver resection or transplantation. METHODS:A retrospective, single-institution analysis of 413 HCC patients from 1999 to 2009. RESULTS:A total of 413 patients with HCC underwent surgical resection (n = 106) and transpl...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822ca66f
更新日期:2011-09-01 00:00:00
abstract::CLINICAL AND LABORATORY STUDIES OF AFP PRODUCING HEPATOMAS DEMONSTRATED THAT: 1) serum AFP levels correlated directly with tumor growth; 2) circulating AFP could be cleared by passive administration of an. excess of anti-AFP; and 3) highly specific anti-AFP functioned as a carrier to localize diagnostic and possibly t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00025
更新日期:1974-10-01 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000000895
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To define the natural history of, and treatment strategy for, blunt traumatic internal carotid artery (ICA) pseudoaneurysms. BACKGROUND:The natural history and management of traumatic ICA pseudoaneurysms is controversial. METHODS:We retrospectively identified all traumatic ICA pseudoaneurysms diagnosed on h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001158
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the results of a vertical rectus abdominis myocutaneus (VRAM) flap after abdomino-perineal resection (APR) for anal cancer (AC). BACKGROUND DATA:APR is the only curative treatment for AC that recurs or persists after radiochemotherapy. To obtain a clear surgical margin, APR frequently includes a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181bce334
更新日期:2009-11-01 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197809000-00013
更新日期:1978-09-01 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章
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更新日期:2020-01-06 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31822638d4
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:This case control study is a detailed analysis of the causes of death and the risk factors of short-term mortality after appendectomy. SUMMARY BACKGROUND DATA:Although death is a rare event after appendectomy, we found a 7-fold excess mortality after appendectomy overall and a 9-fold excess mortality after n...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31821ad9c4
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to emphasize the importance of a subclassification in the TNM staging system of rectal cancer. BACKGROUND:The clinical significance of the mesorectal extension of rectal cancer is unclear. PATIENTS AND METHODS:Data from 463 consecutive patients with stage IIa disease (T3N0) undergo...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3182119331
更新日期:2011-04-01 00:00:00
abstract::In a series of 112 patients who underwent reoperation for primary hyperparathyroidism at the Massachusetts General Hospital between 1930 and 1975, all but 10 were treated successfully. Seventy-five initial explorations had been performed elsewhere, and 37 in our hospital. A total of 110 diseased parathyroids were unco...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197708000-00004
更新日期:1977-08-01 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e986df
更新日期:2010-08-01 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002753
更新日期:2019-08-01 00:00:00
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journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199408000-00009
更新日期:1994-08-01 00:00:00
abstract::Ligation of the brachial artery in the antecubital fossa in children can be performed without limb loss, but the effect on subsequent limb growth is unknown. From 1969 to 1974, brachial artery ligation for insertion of a Scribner shunt was performed in 27 patients with a mean age of 8.4 years (range, 3 to 15 years). W...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199008000-00013
更新日期:1990-08-01 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000247258.35406.a4
更新日期:2006-12-01 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828c8a30
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND AND AIM:Immunomodulating nutrition is supposed to reduce the number of complications and lengthen of hospital stay during the postoperative period in patients after major gastrointestinal surgery. The aim of the study was to assess the clinical effect of immunostimulatory enteral and parenteral nutrition in ...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e318180a3c1
更新日期:2008-08-01 00:00:00
abstract::From 1964 to 1968 selective gastric vagotomy (SGV) and drainage was performed in 174 patients. Of these, 105 patients were followed-up 10-13 years after operation; 56 were dead. Ulcers recurred in 18 patients. The cumulated recurrence rate after 13 years (life table method) was 15% (95% confidence limits: 8-23). The m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198112000-00004
更新日期:1981-12-01 00:00:00
abstract::Circular, full-thickness dermal burn- and freeze-produced wounds were produced in rats to compare the difference in healing between the two types of thermal injuries. Contraction did not occur in wounds (n = 30) caused by freezing, while burn wounds (n = 30) contracted to less than one-third of original size by 21 day...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198002000-00019
更新日期:1980-02-01 00:00:00
abstract::A case report and review of the literature regarding multiple primary melanomas, and a discussion of the histologic differentiation between cutaneous primary melanomas and dermal metastases are presented. This report concerns a patient who, following wide surgical resection of a 1.3 mm thick primary melanoma with sate...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198102000-00021
更新日期:1981-02-01 00:00:00
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doi:10.1097/SLA.0000000000003191
更新日期:2021-01-01 00:00:00