The MISTELS program to measure technical skill in laparoscopic surgery. Surg Endosc

Steinberg-Bernstein Centre for Minimally Invasive Surgery, Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, #L9.309, Montreal, Quebec, H3G 1A4, Canada.
Surgical Endoscopy (Impact Factor: 3.26). 06/2006; 20(5):744-7. DOI: 10.1007/s00464-005-3008-y
Source: PubMed


The McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) is a series of five tasks with an objective scoring system. The purpose of this study was to estimate the interrater and test-retest reliability of the MISTELS metrics and to assess their internal consistency.
To determine interrater reliability, two trained observers scored 10 subjects, either live or on tape. Test-retest reliability was assessed by having 12 subjects perform two tests, the second immediately following the first. Interrater and test-retest reliability were assessed using intraclass correlation coefficients. Internal consistency between tasks was estimated using Cronbach's alpha.
The interrater and test-retest reliabilities for the total scores were both excellent at 0.998 [95% confidence interval (CI), 0.985-1.00] and 0.892 (95% CI, 0.665-0.968), respectively. Cronbach's alpha for the first assessment of the test-retest was 0.86.
The MISTELS metrics have excellent reliability, which exceeds the threshold level of 0.8 required for high-stakes evaluations. These findings support the use of MISTELS for evaluation in many different settings, including residency training programs.

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    • "The MISTELS test battery evaluated the speed and quality of completion for five individual skills pertaining to manipulation of laparoscopic tools. These skills included: pattern cutting, intracorporeal knot tying, extracorporeal knot tying, placement of a ligating loop, and peg-board transfers (Fraser et al., 2003; Vassiliou et al., 2006). Interestingly, little research has explored the effect of stereoscopic viewing environments or spatial visualization ability (Vz) on the performance of skills like those sampled in the MISTELS tasks. "
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    • "Laparoscopic surgery requires high skill in the use of surgical instruments, adaptation to limited workspace, and adaptation to the loss of information due to the depth. Therefore, the training of the surgeon's skills [1], [2] and the development of new training systems which contribute significantly to the surgeon's improvement of surgical and technical skills are very important. Physical training systems [3], [4] and virtual reality and augmented reality simulators [5], [6] have shown their efficiency for learning and continuous improvement of the surgeon's psychomotor skills. "
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    World Acad Sci Eng Technol Int J Med Health, Amsterdam, The Netherlands; 08/2013
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    • "Laparoscopic surgery brings significant benefits to patients intra-and post-operatively. Recently, a number of surgical simulators, both physical, model-based and softwarebased , have been developed, all allowing trainees to safely master the basics skills such as depth perception, dexterity, or hand-eye coordination [6], [8], [9], [13]. This paper focuses on the next generation of the Computer-Assisted Surgical Training System (CAST) [2], designed particularly for the skill-based behavior training of laparoscopic surgeons [3]. "
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