title: Preliminary Study of Video-Based Pediatric Endoscopic Surgical Skill Assessment Using a Neonatal Esophageal Atresia/Tracheoesophageal Fistula Model.
abstract: OBJECTIVE
  Thoracoscopic esophageal atresia/tracheoesophageal fistula (EA/TEF) repair in neonates is technically difficult because of the small working space and fragility of tissues. This study aimed to show the construct validity of the neonatal EA/TEF simulator by video-based assessment of endoscopic suturing skill.
  
  
  METHODS
  A rapid-prototyped neonatal chest model with an artificial esophagus model similar to the actual neonatal esophagus was developed. Forty pediatric surgeons performed an endoscopic intracorporeal suturing task and a knot-tying task using the model, and a questionnaire survey was administered. Each task was video recorded and assessed using two skill assessment methods (the 29-point checklist method and the error assessment sheet method). The task completion time and the number of manipulations were measured.
  
  
  RESULTS
  With regard to experience in performing thoracoscopic TEF repair, the experienced surgeons (ESs, ≥3 EA/TEF repair experiences, n = 6) were significantly superior to the inexperienced surgeons (ISs, <3 experiences, n = 34) in all metrics. Upon comparison by the pediatric Endoscopic Surgical Skill Qualification (ESSQ) status, there were no significant differences in all metrics between the ESSQ-qualified (n = 15) and nonqualified (n = 25) surgeons. The qualified ESs (n = 6) were significantly superior to the qualified ISs (n = 9) in all metrics.
  
  
  CONCLUSIONS
  Video-based endoscopic surgical skill assessment using the neonatal EA/TEF simulator could differentiate ESs from ISs. The construct validity of the simulator was demonstrated, and the simulator would be useful especially for practicing thoracoscopic EA/TEF procedures.
authors.affiliation: 1 Department of Pediatric Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo , Tokyo, Japan .
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Deie
authors.affiliation: 1 Department of Pediatric Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo , Tokyo, Japan .
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ishimaru
authors.affiliation: 1 Department of Pediatric Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo , Tokyo, Japan .
authors.forename: Shinya
authors.initials: S
authors.lastname: Takazawa
authors.affiliation: 2 School of Engineering, The University of Tokyo , Tokyo, Japan .
authors.forename: Kanako
authors.initials: K
authors.lastname: Harada
authors.affiliation: 2 School of Engineering, The University of Tokyo , Tokyo, Japan .
authors.forename: Naohiko
authors.initials: N
authors.lastname: Sugita
authors.affiliation: 2 School of Engineering, The University of Tokyo , Tokyo, Japan .
authors.forename: Mamoru
authors.initials: M
authors.lastname: Mitsuishi
authors.affiliation: 1 Department of Pediatric Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo , Tokyo, Japan .
authors.forename: Jun
authors.initials: J
authors.lastname: Fujishiro
authors.affiliation: 1 Department of Pediatric Surgery, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo , Tokyo, Japan .|3 Saitama Children's Medical Center , Saitama, Japan .
authors.forename: Tadashi
authors.initials: T
authors.lastname: Iwanaka
mesh_terms: D002983:Clinical Competence; D004933:Esophageal Atresia / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008953:Models, Anatomic; D010372:Pediatrics / Q000592:standards*; D011795:Surveys and Questionnaires; D013537:Sutures; D013647:Task Performance and Analysis; D013906:Thoracoscopy / Q000592:standards*; D014138:Tracheoesophageal Fistula / Q000601:surgery*; D014741:Video Recording
keywords: education; pediatric surgery