title: Assessment tool for total laparoscopic hysterectomy: a Delphi consensus survey among international experts.
abstract: OBJECTIVE
  To achieve consensus among experts on the essentials steps to include in an assessment tool for total laparoscopic hysterectomy.
  
  
  METHODS
  Using a Delphi consensus process, an initial survey was created based on the current literature and local expertise in laparoscopic surgery and sent to international experts in laparoscopic gynaecology. Experts were selected according to specific criteria. A second survey was formulated based on the answers and comments from the first round and sent to all experts who participated in the first round. Consensus was defined as a Cronbach alpha ≥ 0.80. A rate of agreement ≥ 0.70 was used to define which substeps to keep in the final tool.
  
  
  RESULTS
  From the 85 experts invited to participate, 53 (62%) agreed to participate, and 51 of these participated in both rounds. The final instrument to assess total laparoscopic hysterectomy was created using the items with a high level of agreement after two rounds. This final tool showed good internal consistency among the experts, with a Cronbach alpha of 0.90.
  
  
  CONCLUSIONS
  Using a Delphi methodology, we achieved international consensus among experts in laparoscopic gynaecology within a short time frame and with minimal costs. The resulting evaluation tool for total laparoscopic hysterectomy may serve in the assessment of surgical skills in the future, and would be a valuable adjunct to postgraduate training and continuing medical education programs. This tool will now undergo a validation process, comparing the rating scores of novices and experts surgeons.
authors.affiliation: Département d'obstétrique-gynécologie, Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal QC.
authors.forename: Catherine
authors.initials: C
authors.lastname: Tremblay
authors.affiliation: Department of Surgery, University of Toronto, Toronto ON; Keenan Research Centre of the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto ON.
authors.forename: Teodor
authors.initials: T
authors.lastname: Grantcharov
authors.affiliation: Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto ON.
authors.forename: Marcelo L
authors.initials: ML
authors.lastname: Urquia
authors.affiliation: Department of Obstetrics and Gynaecology, St. Michael's Hospital, Toronto ON.
authors.forename: Abheha
authors.initials: A
authors.lastname: Satkunaratnam
mesh_terms: D003697:Delphi Technique; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D011795:Surveys and Questionnaires
keywords: delphi technique; hysterectomy; laparoscopy; surgical skills