Development of Nontechnical Skills Assessment Tool and The Validation Study for Laparoscopic Inguinal Hernia Repair

IF 2.2 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2026-02-01 Epub Date: 2025-12-04 DOI:10.1016/j.jsurg.2025.103799

Zen Naito MD , Saseem Poudel MD, PhD , Keita Ishido MD, PhD , Yo Kurashima MD, PhD , Yoichi M. Ito MD, PhD , Satoshi Hirano MD, PhD

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引用次数: 0

Abstract

Nontechnical skills, such as situational awareness and decision-making, are essential for safe and efficient surgical performance. Although the Nontechnical Skills for Surgeons (NOTSS) framework provides a structured approach, it lacks procedure-specific assessment tools. There remains a significant gap in standardized methods for evaluating and training nontechnical skills in specific surgical procedures.

Objective

To develop and validate a novel assessment tool, KUDAS-TAPP (Kurashima Decision-making and Situation awareness – Trans Abdominal Preperitoneal approach), specifically designed to evaluate nontechnical skills in the TAPP procedure, focusing on situational awareness and decision-making.

Design and Setting

Under the supervision of expert hernia surgeons, we developed the KUDAS-TAPP as an assessment tool for nontechnical skills in TAPP. This tool was used to evaluate 3 groups of surgeons: novices, intermediates, and experts. Participants were assessed by 3 independent raters using the KUDAS-TAPP. Inter-rater reliability was analyzed using the intraclass correlation coefficient (ICC), and construct validity was examined by comparing scores across experience levels.

Results

A total of 21 participants (5 novices, 10 intermediates, and 6 experts) from 11 institutions were included. The inter-rater reliability of KUDAS-TAPP was high (ICC = 0.91, 95% confidence interval (CI) : 0.84 — 0.96), and internal consistency was excellent (Cronbach’s alpha = 0.97). The median KUDAS-TAPP scores differed significantly across experience levels (p < 0.01), with significant differences between novices and experts, and intermediates and experts (p < 0.01). KUDAS-TAPP scores correlated strongly with the number of TAPP procedures performed (ρ = 0.73, p < 0.01), as well as with Global Operative Assessment of Laparoscopic Skills for Groin Hernia (GOALS-GH) (ρ = 0.88, p < 0.01) and TAPP checklist scores (ρ = 0.80, p < 0.01).

Conclusion

The KUDAS-TAPP is a reliable and valid assessment tool for evaluating situational awareness and decision-making in the TAPP procedure. Its application could enhance surgical education and training by providing a structured framework for assessing and improving nontechnical skills. Future research should explore its effectiveness in training programs and adaptability to other surgical procedures.

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腹腔镜腹股沟疝修补术非技术技能评估工具的开发与验证研究。

非技术技能，如态势感知和决策，对于安全和有效的手术表现至关重要。尽管外科医生非技术技能（NOTSS）框架提供了一种结构化的方法，但它缺乏特定于手术的评估工具。在评估和培训特定外科手术非技术技能的标准化方法方面仍存在重大差距。目的：开发并验证一种新的评估工具KUDAS-TAPP （Kurashima decision- and Situation awareness - Trans腹膜前入路），专门用于评估TAPP程序中的非技术技能，重点是情景感知和决策。设计与设置：在疝外科专家的指导下，我们开发了KUDAS-TAPP，作为TAPP非技术技能的评估工具。该工具用于评估3组外科医生：新手、中级和专家。参与者由3位独立评分者使用KUDAS-TAPP进行评估。使用类内相关系数（ICC）分析评等间信度，并通过比较不同经验水平的得分来检验构念效度。结果：共纳入11所院校的21名参与者，其中新手5人，中级10人，专家6人。KUDAS-TAPP的评价间信度高（ICC = 0.91,95%置信区间（CI）： 0.84 ~ 0.96），内部一致性好（Cronbach’s alpha = 0.97）。结论：在TAPP过程中，KUDAS-TAPP是一种可靠有效的评估工具，可用于评估情境感知和决策。它的应用可以通过提供评估和提高非技术技能的结构化框架来加强外科教育和培训。未来的研究应探讨其在训练计划中的有效性和对其他外科手术的适应性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.