title: A simple scoring system to train surgeons in basic laparoscopic skills.
abstract: OBJECTIVE
  To develop and validate a scoring system for a training assessment tool using a box trainer which can objectively demonstrate progression in laparoscopic skills.
  
  
  METHODS
  170 assessments were performed over a 5-year period by doctors working in a busy paediatric surgical department. Each participant was scored based on experience and then undertook six laparoscopic tasks in a box trainer in a dry skills lab. The quicker and more accurate the performance, the lower the score. Validity and reliability tests were applied.
  
  
  RESULTS
  Pearson correlation coefficient demonstrated that more experienced surgeons performed better than novices with an r of -0.63 (p < 0.001). The mean assessment scores improved (reduced) with increasing experience score [4140 (0-20), 2696 (21-40), 1969 (>40) p < 0.001]. Improvement in score was seen at all experience levels with greatest improvement seen in the less experienced (2315, 1820, 1571 p < 0.001). Cronbach's alpha was 0.70 and the intraclass correlation coefficient for test-retest reliability was 0.81.
  
  
  CONCLUSIONS
  Construct validity with adequate reliability has been demonstrated for this simple training tool and scoring system. All experience levels demonstrated improvement in their laparoscopic skills by simulation training in a laparoscopic box trainer.
authors.affiliation: Department of Paediatric Surgery, Oxford Children's Hospital, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK. gshepherd@me.com.
authors.forename: Gregory
authors.initials: G
authors.lastname: Shepherd
authors.affiliation: Red Cross War Memorial Children's Hospital, Rondebosch, Cape Town, South Africa.
authors.forename: Dirk
authors.initials: D
authors.lastname: von Delft
authors.affiliation: Department of Paediatrics, John Radcliffe Hospital, Oxford, UK.
authors.forename: Johannes
authors.initials: J
authors.lastname: Truck
authors.affiliation: Department of Paediatric Surgery, Mannheim Medical School (UMM), University of Heidelberg, Heidelberg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Kubiak
authors.affiliation: Department of Paediatric Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
authors.forename: Khaled
authors.initials: K
authors.lastname: Ashour
authors.affiliation: Department of Paediatric Surgery, Oxford Children's Hospital, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Hugh
authors.initials: H
authors.lastname: Grant
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D010372:Pediatrics / Q000193:education; D015203:Reproducibility of Results; D066231:Surgeons / Q000193:education*
keywords: Assessment tool; Laparoscopy; Simulation; Training