title: Towards development and validation of an intraoperative assessment tool for robot-assisted radical prostatectomy training: results of a Delphi study.
abstract: BACKGROUND
  As urology training shifts toward competency-based frameworks, the need for tools for high stakes assessment of trainees is crucial. Validated assessment metrics are lacking for many robot-assisted radical prostatectomy (RARP). As it is quickly becoming the gold standard for treatment of localized prostate cancer, the development and validation of a RARP assessment tool for training is timely.
  
  
  METHODS
  We recruited 13 expert RARP surgeons from the United States and Canada to serve as our Delphi panel. Using an initial inventory developed via a modified Delphi process with urology residents, fellows, and staff at our institution, panelists iteratively rated each step and sub-step on a 5-point Likert scale of agreement for inclusion in the final assessment tool. Qualitative feedback was elicited for each item to determine proper step placement, wording, and suggestions.
  
  
  RESULTS
  Panelist's responses were compiled and the inventory was edited through three iterations, after which 100% consensus was achieved. The initial inventory steps were decreased by 13% and a skip pattern was incorporated. The final RARP stepwise inventory was comprised of 13 critical steps with 52 sub-steps. There was no attrition throughout the Delphi process.
  
  
  CONCLUSIONS
  Our Delphi study resulted in a comprehensive inventory of intraoperative RARP steps with excellent consensus. This final inventory will be used to develop a valid and psychometrically sound intraoperative assessment tool for use during RARP training and evaluation, with the aim of increasing competency of all trainees.
authors.affiliation: Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada.
authors.forename: Christopher
authors.initials: C
authors.lastname: Morris
authors.affiliation: Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada.
authors.forename: Jen
authors.initials: J
authors.lastname: Hoogenes
authors.affiliation: Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada.
authors.forename: Bobby
authors.initials: B
authors.lastname: Shayegan
authors.affiliation: Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003697:Delphi Technique; D006801:Humans; D007396:Internship and Residency; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000193:education* / Q000379:methods; D065287:Robotic Surgical Procedures / Q000193:education* / Q000379:methods; D000066908:Simulation Training / Q000379:methods*; D013647:Task Performance and Analysis; D014572:Urology / Q000193:education
keywords: Delphi Technique; Prostatectomy; Robotic Surgical Procedures