Laparoscopic common bile duct exploration four-task training model: construct validity.
BACKGROUND
Training models in laparoscopic surgery allow the surgical team to practice procedures in a safe environment. We have proposed the use of a 4-task, low-cost inert model to practice critical steps of laparoscopic common bile duct exploration.


METHODS
The  performance of 3 groups with different levels of expertise in laparoscopic surgery, novices (A), intermediates (B), and experts (C), was evaluated using a low-cost inert model in the following tasks: (1) intraoperative cholangiography catheter insertion, (2) transcystic exploration, (3) T-tube  placement, and (4) choledochoscope management. Kruskal-Wallis and Mann-Whitney tests were used to identify differences among the groups.


RESULTS
A total of 14 individuals were evaluated: 5 novices (A), 5 intermediates (B), and 4 experts (C). The results involving intraoperative  cholangiography catheter insertion were similar among the 3 groups. As for the other tasks, the expert had better results than the other 2, in which no significant differences occurred. The proposed model is able to discriminate among individuals with different levels of expertise, indicating  that the abilities that the model evaluates are relevant in the surgeon's performance in CBD exploration.


CONCLUSIONS
Construct validity for tasks 2 and 3 was demonstrated. However, task 1 was no capable of distinguishing between groups, and task 4 was not statistically validated.
Faculty of Medicine, Central University of Venezuela, Surgery Department III, University Hospital of Caracas, Caracas, Venezuela. dralexissanchez@hotmail.com
Alexis
A
Sánchez
Natalia
N
Otaño
Omaira
O
Rodríguez
Renata
R
Sánchez
Gustavo
G
Benítez
Michael
M
Schweitzer
D042883:Choledocholithiasis / Q000601:surgery; D003135:Common Bile Duct / Q000601:surgery*; D013502:General Surgery / Q000193:education*; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D013663:Teaching / Q000379:methods*; D013664:Teaching Materials