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      What Are the Principles That Guide Behaviors in the Operating Room? : Creating a Framework to Define and Measure Performance

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          Abstract

          To identify the core principles that guide expert intraoperative behaviors and to use these principles to develop a universal framework that defines intraoperative performance.

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          The role of deliberate practice in the acquisition of expert performance.

          K. Ericsson, Ralf T H Krampe, Clemens Tesch-Römer (1993)
          Article 0 comments Cited 1147 times – based on 0 reviews     Review now
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            Categorization and Representation of Physics Problems by Experts and Novices*

            Michelene T H Chi, Paul Feltovich, Robert Glaser (1981)
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              A global assessment tool for evaluation of intraoperative laparoscopic skills.

              Lena Andrew, Karen Leffondre, Melina C Vassiliou … (2005)
              There is a pressing need for an intraoperative assessment tool that meets high standards of reliability and validity to use as an outcome measure for different training strategies. The aim of this study was to develop a tool specific for laparoscopic skills and to evaluate its reliability and validity. The Global Operative Assessment of Laparoscopic Skills (GOALS) consists of a 5-item global rating scale. A 10-item checklist and 2 visual analogue scales (VAS) for competence and case difficulty were also used. During laparoscopic cholecystectomy, 21 participants were evaluated by the attending surgeon, by 2 trained observers and by self-assessment while dissecting the gallbladder from the liver bed. The intraclass correlation coefficient (ICC) for the total GOALS score was .89 (95% confidence interval [CI] .74 to .95) between observers, .82 (95% CI .67 to .92) between observers and attending surgeons, and .70 (95% CI .37 to .87) between participants and attending surgeons. The ICCs (observers) for the VAS (competence) and the checklist were .69 and .70, respectively. The mean total GOALS score (observers) for novices (postgraduate years [PGYs] 1 through 3) was 13 (95% CI 10.3 to 15.7) compared with 19.4 (95% CI 17.2 to 21.5) for experienced (PGY 4 through attending surgeons, P = .0006). The VAS demonstrated a difference in scores between novice and experienced participants (P = .001); however, the task checklist did not (P = .09). These data indicate that GOALS is feasible, reliable, and valid. They also suggest that it is superior to the task checklist and VAS for evaluation of technical skill by experienced raters. The findings support the use of GOALS in the training and evaluation of laparoscopic skills.
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                Author and article information

                Journal
                Title: Annals of Surgery
                Abbreviated Title: Annals of Surgery
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 0003-4932
                Publication date Created: 2017
                Publication date (Print): February 2017
                Volume: 265
                Issue: 2
                Pages: 255-267
                Article
                DOI: 10.1097/SLA.0000000000001962
                PubMed ID: 27611618
                SO-VID: a9229a76-d011-4515-94e3-49cdf02b2d90
                Copyright © © 2017
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