title: Validation of the Simulator for Testing and Rating Endovascular SkillS (STRESS)-machine in a setting of competence testing.
abstract: OBJECTIVE
  Endovascular skills are an integral part of modern-day vascular surgery. The STRESS machine has been developed to test these skills in vascular surgeons. This study aims to define an optimal pass/fail cutoff value for the STRESS test score.
  
  
  METHODS
  The STRESS machine consists of a dry glass model of the abdominal aorta and its tributaries with various stenotic lesions, elongations, and tortuosities. A camera and computer software are used to simulate plain fluoroscopy-mode. The test subjects are given two assignments after which two reviewers use a combination of the ICEPS and MRS to produce the final total score; 43 subjects were tested. According to previous endovascular experience, subjects were classified into four groups: novice-low (no experience, less than 11 performed procedures, less than 50 assisted procedures), novice-high (11-25 performed procedures, more than 50 assisted procedures), intermediate (1-10 performed and >11-25 assisted procedures, 11-25 performed and >1-10 assisted procedures or 25-50 performed procedures) and advanced (more than 50 performed procedures).
  
  
  RESULTS
  Test-score and noted experience showed a correlation of 0.794. All intermediate and advanced test subjects scored more than 50 points compared to 4 out of 15 novices.
  
  
  CONCLUSIONS
  We demonstrated that it is possible to determine an optimal cut-off value for competence testing with the STRESS machine.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands. p.berger@chir.umcn.nl
authors.forename: P
authors.initials: P
authors.lastname: Berger
authors.forename: M C M
authors.initials: MC
authors.lastname: Willems
authors.forename: J A
authors.initials: JA
authors.lastname: Van Der Vliet
authors.forename: L J
authors.initials: LJ
authors.lastname: Schultze Kool
authors.forename: D
authors.initials: D
authors.lastname: Bergqvist
authors.forename: J D
authors.initials: JD
authors.lastname: Blankensteijn
mesh_terms: D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D002983:Clinical Competence; D003198:Computer Simulation; D006801:Humans; D009048:Motor Skills; D017063:Outcome Assessment, Health Care; D011859:Radiography; D015203:Reproducibility of Results; D013647:Task Performance and Analysis; D014656:Vascular Surgical Procedures