title: Camera navigation and cannulation: validity evidence for new educational tasks to complement the Fundamentals of Laparoscopic Surgery program.
abstract: BACKGROUND
  Experts identified camera navigation and cannulation as important skills that are not assessed by the Fundamentals of Laparoscopic Surgery (FLS) hands-on examination. The purpose of this study was to create metrics for and evaluate the validity for two new tasks: camera navigation (N) and cannulation (C), and to explore the potential value of adding these tasks to the FLS program.
  
  
  METHODS
  Participants were assessed by two raters during performance of N and C in addition to the five standard FLS tasks. They also completed a questionnaire regarding the educational value of the new tasks. Validity evidence was assessed by comparing performance between Novice (PGY 1 and 2) and Experienced (PGY 3 and higher) participants, and by correlating new task scores with standard FLS scores. The ability to predict level of training using scores was evaluated by regression analysis.
  
  
  RESULTS
  Sixty subjects participated from five North American centers. Inter-rater reliabilities for both tasks were 0.99. Novice and Experienced participants scored 74 ± 17.8 versus 85 ± 8.3 (p < 0.01) and 21 ± 17.3 versus 39 ± 20.1 (p < 0.01) on N and C tasks, respectively. Correlations with total FLS scores for N and C were 0.39 and 0.53, respectively. Prediction of training level using the combination of all seven tasks was 52.6 % (R (2) = 0.526, p < 0.01), adding an additional 2.2 % to the five FLS tasks. Of 55 participants with laparoscopic experience, 51 % reported N to be similar in difficulty to reality. Of 28 participants who perform intraoperative cholangiograms, 43 % found C to be more difficult than reality. Most (70 %) participants thought the new tasks added value to FLS.
  
  
  CONCLUSIONS
  This study provides preliminary validity evidence for the metrics of these new tasks. The value of adding these tasks to the FLS manual skills assessment is marginal in terms of predicting level of training.
authors.affiliation: Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, Room L9-313, Montreal, QC, H3G 1A4, Canada, yusuke.watanabe@mail.mcgill.ca.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: E
authors.initials: E
authors.lastname: Matt Ritter
authors.forename: Steven D
authors.initials: SD
authors.lastname: Schwaitzberg
authors.forename: James R
authors.initials: JR
authors.lastname: Korndorffer
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Scott
authors.forename: Allan
authors.initials: A
authors.lastname: Okrainec
authors.forename: Elif
authors.initials: E
authors.lastname: Bilgic
authors.forename: Pepa A
authors.initials: PA
authors.lastname: Kaneva
authors.forename: Mary T
authors.initials: MT
authors.lastname: O'Donnell
authors.forename: Liane S
authors.initials: LS
authors.lastname: Feldman
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Fried
authors.forename: Melina C
authors.initials: MC
authors.lastname: Vassiliou
mesh_terms: D000328:Adult; D002404:Catheterization / Q000379:methods*; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000295:instrumentation*; D008297:Male; D009656:North America; D015397:Program Evaluation; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014741:Video Recording / Q000295:instrumentation*