title: A pilot study to assess the construct and face validity of the Northwestern Objective Microanastomosis Assessment Tool.
abstract: OBJECTIVE
  Microsurgical skills remain an integral component of neurosurgical education. There is a need for an objective scale to assess microsurgical skills. The objective of this study was to assess the face and construct validity of a bench training microanastomosis module and an objective assessment scale, i.e., the Northwestern Objective Microanastomosis Assessment Tool (NOMAT).
  
  
  METHODS
  Medical students, neurosurgical residents, and postdoctoral research fellows at Northwestern University were enrolled in the study. Trainees were divided into 3 groups based on microsurgical experience: 1) experienced, 2) exposed, and 3) novices. Each trainee completed two end-to-end microanastomoses using a 1-mm and a 3-mm synthetic vessel. Two cameras were installed to capture procedural footage. One neurosurgeon blindly graded the performance of trainees using both objective and subjective methods to assess construct validity. Two neurosurgeons reviewed the contents of the simulation module to assess face validity.
  
  
  RESULTS
  Twenty-one trainees participated in the study, including 6 experienced, 6 exposed, and 9 novices. The mean NOMAT score for experienced trainees on the 1-mm module was 47.3/70 compared with 26.0/70 and 25.8/70 for exposed and novice trainees, respectively (p = 0.02). Using subjective grading, experienced trainees performed significantly better on the 1-mm module (64.2/100) compared with exposed or novice trainees (23.3/100 and 25.0/100, respectively; p = 0.02). No statistical difference between groups was noted for the 3-mm module with both NOMAT and subjective grading. Experienced trainees took less time to perform both tasks compared with the others.
  
  
  CONCLUSIONS
  Face and construct validities of the microanastomosis module were established. The scale and the microanastomosis module could help assess the microsurgical skills of neurosurgical trainees and serve as a basis for the creation of a microsurgical curriculum.
authors: Department of Neurological Surgery, University of Texas Southwestern, Dallas, Texas; and 
authors: Salah G
authors: SG
authors: Aoun
authors: Department of Neurological Surgery, University of Texas Southwestern, Dallas, Texas; and 
authors: Tarek Y
authors: TY
authors: El Ahmadieh
authors: Departments of 2 Neurological Surgery.
authors: Najib E
authors: NE
authors: El Tecle
authors: Departments of 2 Neurological Surgery.
authors: Marc R
authors: MR
authors: Daou
authors: Departments of 2 Neurological Surgery.
authors: Joseph G
authors: JG
authors: Adel
authors: Anesthesiology, and.
authors: Christine S
authors: CS
authors: Park
authors: Department of Neurological Surgery, University of Texas Southwestern, Dallas, Texas; and 
authors: H Hunt
authors: HH
authors: Batjer
authors: Departments of 2 Neurological Surgery.|Radiology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors: Bernard R
authors: BR
authors: Bendok
mesh_terms: D000714:Anastomosis, Surgical / Q000193:education / Q000295:instrumentation / Q000379:methods*; D003479:Curriculum / Q000592:standards*; D004502:Education, Medical, Continuing / Q000592:standards; D006801:Humans; D007087:Illinois; D008866:Microsurgery / Q000193:education / Q000295:instrumentation / Q000379:methods*; D010865:Pilot Projects; D013663:Teaching / Q000592:standards
keywords: NOMAT = Northwestern Objective Microanastomosis Assessment Tool; OSATS = Objective Structured Assessment of Technical Skill; microanastomosis; microsurgery; objective assessment scale; resident training; simulation in neurosurgery; validity; vascular disorders