title: Multi-Institutional Validation of an OSATS for the Assessment of Cystoscopic and Ureteroscopic Skills.
abstract: OBJECTIVE
  We evaluated the internal and construct validity of an assessment tool for cystoscopic and ureteroscopic cognitive and psychomotor skills at a multi-institutional level.
  
  
  METHODS
  Subjects included a total of 30 urology residents at Ohio State University, Columbus, Ohio; Penn Presbyterian Medical Center, Philadelphia, Pennsylvania; and Mayo Clinic, Rochester, Minnesota. A single external blinded reviewer evaluated cognitive and psychomotor skills associated with cystoscopic and ureteroscopic surgery using high fidelity bench models. Exercises included navigation, basketing and relocation; holmium laser lithotripsy; and cystoscope assembly. Each resident received a total cognitive score, checklist score and global psychomotor skills score. Construct validity was assessed by calculating correlations between training year and performance scores (both cognitive and psychomotor). Internal validity was confirmed by calculating correlations between test components.
  
  
  RESULTS
  The median total cognitive score was 91 (IQR 86.25, 97). For psychomotor performance residents had a median total checklist score of 7 (IQR 5, 8) and a median global psychomotor skills score of 21 (IQR 18, 24.5). Construct validity was supported by the positive and statistically significant correlations between training year and total cognitive score (r = 0.66, 95% CI 0.39-0.82, p = 0.01), checklist scores (r = 0.66, 95% CI 0.35-0.84, p = 0.32) and global psychomotor skills score (r = 0.76, 95% CI 0.55-0.88, p = 0.002). The internal validity of OSATS was supported since total cognitive and checklist scores correlated with the global psychomotor skills score.
  
  
  CONCLUSIONS
  In this multi-institutional study we successfully demonstrated the construct and internal validity of an objective assessment of cystoscopic and ureteroscopic cognitive and technical skills, including laser lithotripsy.
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, Minnesota; Department of Urology, Acibadem University, Istanbul, Turkey.
authors.forename: Omer Burak
authors.initials: OB
authors.lastname: Argun
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, Minnesota; Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota.
authors.forename: Kristin
authors.initials: K
authors.lastname: Chrouser
authors.affiliation: Seeger Simulation Training and Research Center, Baylor University Medical Center, Dallas, Texas.
authors.forename: Sanket
authors.initials: S
authors.lastname: Chauhan
authors.affiliation: Department of Urology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Manoj
authors.initials: M
authors.lastname: Monga
authors.affiliation: Department of Urology, Ohio State University, Columbus, Ohio.
authors.forename: Bodo
authors.initials: B
authors.lastname: Knudsen
authors.affiliation: Department of Urology, Ohio State University, Columbus, Ohio.
authors.forename: Geoffrey N
authors.initials: GN
authors.lastname: Box
authors.affiliation: Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: David I
authors.initials: DI
authors.lastname: Lee
authors.affiliation: Department of Urology, Mayo Medical School and Mayo Clinic, Rochester, Minnesota.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Gettman
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Lauren H
authors.initials: LH
authors.lastname: Poniatowski
authors.affiliation: Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Troy E
authors.initials: TE
authors.lastname: Reihsen
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, Minnesota. Electronic address: rsweet@umn.edu.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Sweet
mesh_terms: D000328:Adult; D057189:Checklist; D002983:Clinical Competence; D003558:Cystoscopy; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007396:Internship and Residency; D008297:Male; D011597:Psychomotor Performance
keywords: endoscopy; internship and residency; psychomotor performance; ureter; urinary bladder