Reliability Study of the Laparoscopic Skills Index (LSI): a new measure of gynaecologic laparoscopic surgical skills.
OBJECTIVE
To construct and test the reliability of the Laparoscopic Skills Index (LSI) as a new, multi-item, objective measure of laparoscopic skills in gynaecology.


METHODS
Construction of the LSI involved (1). item selection, (2). choosing a method to scale responses, (3). design, and (4). choosing a scoring method. Internal consistency and rater reliability were tested. One community-based gynaecologist (rater A) and 3 teaching faculty gynaecologists (raters B, C, and D) reviewed 20 videotaped gynaecologic laparoscopy operations and scored operator (subject) performance.


RESULTS
Cronbach's a was 0.95, indicating a high level of internal consistency. The intraclass correlation coefficient (ICC) for all 4 raters was 0.51 (95% confidence interval [CI], 0.20-0.76), indicative of moderate interrater reliability. A systematic observer bias was seen wherein rater A's scores closely paralleled, but were consistently higher than, those of raters B, C, and D. The ICC for raters B, C, and D only was 0.77 (95% CI, 0.56-0.90), which is consistent with very good rater agreement.


CONCLUSIONS
The LSI appears to have the properties of a reliable, unidimensional index, in which the item variables are true components of the overall attribute, that is, laparoscopic skill.
Shime
Jerry
J
Department of Obstetrics and Gynaecology, University of Toronto Medical School, Toronto, ON, Canada.
Pittini
Richard
R
Szalai
Jean Paul
JP
D002983:Clinical Competence; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000592:standards*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000592:standards*; D019370:Observation; D015588:Observer Variation; D015203:Reproducibility of Results; D014743:Videotape Recording