Objective assessment of laparoscopic rectal cancer trainee performance
Research type
Research Study
Full title
Validity and reliability of intraoperative objective laparoscopic rectal cancer performance assessment tools in residency training
IRAS ID
264535
Contact name
Nathan Curtis
Contact email
Sponsor organisation
Northwick Park Institute of Medical Research
Duration of Study in the UK
1 years, 2 months, 17 days
Research summary
Keyhole rectal cancer surgery is a challenging procedure that requires advanced surgical skills. Patient outcomes are linked to the quality of surgery performed. The role of keyhole surgery for rectal cancer is hotly debated as although this helps patients recover faster, recent research trials have raised concerns about the quality of cancer surgery being performed by this route.
Training surgeons is an important route towards delivering good operations but there are currently no assessment tools to assess trainee performance and guide training in keyhole rectal surgery. To address this need two new dedicated tools have been designed. The global assessment scale (GAS) aims to enhance learning and guide individual's training objectives. The laparoscopic TME performance tool (L-TMEpt) represents an assessment instrument to measure competency at the end of surgical training. In our pilot work the tools were applicable to clinical practice, valid and reliable for the assessment of consultant surgeon performance within two multicentre keyhole rectal cancer trials. There are no reports investigating their use in the training setting but this now requires investigation.
Research question: Are the global assessment scale (GAS) and total mesorectal excision performance tool (L-TMEpt) objective tools valid and reliable for the assessment of intraoperative laparoscopic rectal cancer performance within the residency training setting?
Methodology: Multi-national prospective, observational study of intraoperative laparoscopic rectal cancer performance in 35 senior colorectal residents between October 2019-September 2020. Upon completion of all supervised laparoscopic rectal cancer cases, the trainee and trainer will independently complete the GAS alongside existing training assessments. When GAS scores indicate proficiency, the L-TMEpt will be utilised in a similar fashion.
Scores will be collated centrally alongside anonymised clinical and cancer specimen data to produce measure trainee progression. Tool scores will be investigated patient outcomes and trainee self-assessment will be compared to trainer scores.
Summary: We propose to prospectively apply two bespoke laparoscopic rectal cancer performance assessment tools to investigate their validity and reliability in the resident training setting. Our ultimate aim is to quantify and guide training to ensure future high quality laparoscopic rectal cancer surgery and the delivery of optimal patient outcomes.REC name
London - Surrey Borders Research Ethics Committee
REC reference
19/LO/1440
Date of REC Opinion
18 Oct 2019
REC opinion
Further Information Favourable Opinion