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Reliable Assessment of Laparoscopic Performance in the Operating Room Using Videotape Analysis

Boston University Medical Center, Department of Surgery, Boston, Massachusetts

Nancy J. Hogle, MS

Columbia University, College of Physicians and Surgeons, Department of Surgery, New York, New York

Brianna B. Moore, MA

College of Physicians and Surgeons, Columbia University, Center for Education Research and Evaluation, New York, New York

Mark J. Graham, PhD

College of Physicians and Surgeons, Columbia University, Center for Education Research and Evaluation, New York, New York

Mika N. Sinanan, MD, PhD

University of Washington Medical Center, Department of Surgery, Seattle, Washington

Robert Bailey, MD

University of Miami Medical Center, Department of Surgery, Miami, Florida

Dennis L. Fowler, MD

Columbia University, College of Physicians and Surgeons, Department of Surgery, New York, New York, dlf91{at}columbia.edu

The Global Operative Assessment of Laparoscopic Skills (GOALS) is a valid assessment tool for objectively evaluating the technical performance of laparoscopic skills in surgery residents. We hypothesized that GOALS would reliably differentiate between an experienced (expert) and an inexperienced (novice) laparoscopic surgeon (construct validity) based on a blinded videotape review of a laparoscopic cholecystectomy procedure. Ten board-certified surgeons actively engaged in the practice and teaching of laparoscopy reviewed and evaluated the videotaped operative performance of one novice and one expert laparoscopic surgeon using GOALS. Each reviewer recorded a score for both the expert and the novice videotape reviews in each of the 5 domains in GOALS (depth perception, bimanual dexterity, efficiency, tissue handling, and overall competence). The scores for the expert and the novice were compared and statistically analyzed using single-factor analysis of variance (ANOVA). The expert scored significantly higher than the novice did in the domains of depth perception (p = .005), bimanual dexterity (p = .001), efficiency (p = .001), and overall competence ( p = .001). Interrater reliability for the reviewers of the novice tape was Cronbach alpha = .93 and the expert tape was Cronbach alpha = .87. There was no difference between the two for tissue handling. The Global Operative Assessment of Laparoscopic Skills is a valid, objective assessment tool for evaluating technical surgical performance when used to blindly evaluate an intraoperative videotape recording of a laparoscopic procedure.

Key Words: laparoscopic skills • GOALS • resident evaluation • surgical training • skills assessment

Surgical Innovation, Vol. 14, No. 2, 122-126 (2007)
DOI: 10.1177/1553350607301742


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