Validation of a high-fidelity training model for fetoscopic spina bifida surgery

Abstract Open fetal surgery for spina bifida (SB) is safe and effective yet invasive. The growing interest in fetoscopic SB repair (fSB-repair) prompts the need for appropriate training. We aimed to develop and validate a high-fidelity training model for fSB-repair. fSB-repair was simulated in the a...

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Autores principales:	Luc Joyeux, Allan Javaux, Mary P. Eastwood, Felix R. De Bie, Gert Van den Bergh, Rebecca S. Degliuomini, Simen Vergote, Talita Micheletti, Geertje Callewaert, Sebastien Ourselin, Paolo De Coppi, Frank Van Calenbergh, Emmanuel Vander Poorten, Jan Deprest
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/bf952939a99a450bad855f3ba4c9fd12
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spelling	oai:doaj.org-article:bf952939a99a450bad855f3ba4c9fd122021-12-02T11:39:47ZValidation of a high-fidelity training model for fetoscopic spina bifida surgery10.1038/s41598-021-85607-62045-2322https://doaj.org/article/bf952939a99a450bad855f3ba4c9fd122021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-85607-6https://doaj.org/toc/2045-2322Abstract Open fetal surgery for spina bifida (SB) is safe and effective yet invasive. The growing interest in fetoscopic SB repair (fSB-repair) prompts the need for appropriate training. We aimed to develop and validate a high-fidelity training model for fSB-repair. fSB-repair was simulated in the abdominal cavity and on the stomach of adult rabbits. Laparoscopic fetal surgeons served either as novices (n = 2) or experts (n = 3) based on their experience. Technical performance was evaluated using competency Cumulative Sum (CUSUM) analysis and the group splitting method. Main outcome measure for CUSUM competency was a composite binary outcome for surgical success, i.e. watertight repair, operation time ≤ 180 min and Objective-Structured-Assessment-of-Technical-Skills (OSATS) score ≥ 18/25. Construct validity was first confirmed since competency levels of novices and experts during their six first cases using both methods were significantly different. Criterion validity was also established as 33 consecutive procedures were needed for novices to reach competency using learning curve CUSUM, which is a number comparable to that of clinical fSB-repair. Finally, we surveyed expert fetal surgeons worldwide to assess face and content validity. Respondents (26/49; 53%) confirmed it with ≥ 71% of scores for overall realism ≥ 4/7 and usefulness ≥ 3/5. We propose to use our high-fidelity model to determine and shorten the learning curve of laparoscopic fetal surgeons and retain operative skills.Luc JoyeuxAllan JavauxMary P. EastwoodFelix R. De BieGert Van den BerghRebecca S. DegliuominiSimen VergoteTalita MichelettiGeertje CallewaertSebastien OurselinPaolo De CoppiFrank Van CalenberghEmmanuel Vander PoortenJan DeprestNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Luc Joyeux Allan Javaux Mary P. Eastwood Felix R. De Bie Gert Van den Bergh Rebecca S. Degliuomini Simen Vergote Talita Micheletti Geertje Callewaert Sebastien Ourselin Paolo De Coppi Frank Van Calenbergh Emmanuel Vander Poorten Jan Deprest Validation of a high-fidelity training model for fetoscopic spina bifida surgery
description	Abstract Open fetal surgery for spina bifida (SB) is safe and effective yet invasive. The growing interest in fetoscopic SB repair (fSB-repair) prompts the need for appropriate training. We aimed to develop and validate a high-fidelity training model for fSB-repair. fSB-repair was simulated in the abdominal cavity and on the stomach of adult rabbits. Laparoscopic fetal surgeons served either as novices (n = 2) or experts (n = 3) based on their experience. Technical performance was evaluated using competency Cumulative Sum (CUSUM) analysis and the group splitting method. Main outcome measure for CUSUM competency was a composite binary outcome for surgical success, i.e. watertight repair, operation time ≤ 180 min and Objective-Structured-Assessment-of-Technical-Skills (OSATS) score ≥ 18/25. Construct validity was first confirmed since competency levels of novices and experts during their six first cases using both methods were significantly different. Criterion validity was also established as 33 consecutive procedures were needed for novices to reach competency using learning curve CUSUM, which is a number comparable to that of clinical fSB-repair. Finally, we surveyed expert fetal surgeons worldwide to assess face and content validity. Respondents (26/49; 53%) confirmed it with ≥ 71% of scores for overall realism ≥ 4/7 and usefulness ≥ 3/5. We propose to use our high-fidelity model to determine and shorten the learning curve of laparoscopic fetal surgeons and retain operative skills.
format	article
author	Luc Joyeux Allan Javaux Mary P. Eastwood Felix R. De Bie Gert Van den Bergh Rebecca S. Degliuomini Simen Vergote Talita Micheletti Geertje Callewaert Sebastien Ourselin Paolo De Coppi Frank Van Calenbergh Emmanuel Vander Poorten Jan Deprest
author_facet	Luc Joyeux Allan Javaux Mary P. Eastwood Felix R. De Bie Gert Van den Bergh Rebecca S. Degliuomini Simen Vergote Talita Micheletti Geertje Callewaert Sebastien Ourselin Paolo De Coppi Frank Van Calenbergh Emmanuel Vander Poorten Jan Deprest
author_sort	Luc Joyeux
title	Validation of a high-fidelity training model for fetoscopic spina bifida surgery
title_short	Validation of a high-fidelity training model for fetoscopic spina bifida surgery
title_full	Validation of a high-fidelity training model for fetoscopic spina bifida surgery
title_fullStr	Validation of a high-fidelity training model for fetoscopic spina bifida surgery
title_full_unstemmed	Validation of a high-fidelity training model for fetoscopic spina bifida surgery
title_sort	validation of a high-fidelity training model for fetoscopic spina bifida surgery
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/bf952939a99a450bad855f3ba4c9fd12
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Validation of a high-fidelity training model for fetoscopic spina bifida surgery

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