title: Reliability of a procedural checklist as a high-stakes measurement of advanced technical skill.
abstract: BACKGROUND
  The purpose of this study was to determine the reliability of a previously validated laparoscopic Nissen fundoplication procedural checklist as a measurement of advanced technical skill.
  
  
  METHODS
  Five surgeons, using a 65-step procedural checklist, independently evaluated 2 video recordings of expert surgeon operative performances of a laparoscopic Nissen fundoplication. Results were analyzed for percent agreement and Fleiss kappa correlation for each operation independently and combined as a whole.
  
  
  RESULTS
  Sixty-four of the 65 steps had 80% or higher percent agreement for both operative case A and B independently and when considered overall. The Fleiss kappa coefficients for operative case A (kappa = .95) and operative case B (kappa = .96) and overall (operative case A + B) (kappa = .95).
  
  
  CONCLUSIONS
  The percentage agreement and kappa coefficients for all 3 analyses indicate a high degree of reliability (>.80) that would support the use of this instrument for high-stakes assessment of a laparoscopic Nissen fundoplication.
authors.affiliation: Department of Surgery, Brigham and Women's Hospital, 75 Francis Street, Neville House, Boston, MA 02115, USA. speyre@partners.org
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Peyré
authors.forename: Christian G
authors.initials: CG
authors.lastname: Peyré
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Hagen
authors.forename: Maura E
authors.initials: ME
authors.lastname: Sullivan
mesh_terms: D057189:Checklist / Q000592:standards*; D002983:Clinical Competence; D005260:Female; D018662:Fundoplication / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010818:Practice Patterns, Physicians'; D011786:Quality Control; D015203:Reproducibility of Results; D013647:Task Performance and Analysis; D014743:Videotape Recording