Objective Structured Assessment of Technical Skills for the Photoselective Vaporization of the Prostate Procedure: A Pilot Study.

INTRODUCTION AND OBJECTIVES: Photoselective vaporization of the prostate (PVP) is a frequently performed procedure by postgraduate trainees (PGTs). However, there is no PVP-specific objective assessment tool to evaluate the acquisition of PVP skills. The aim of the present study was to develop and validate an objective structured assessment of technical skills tool for the PVP procedure (PVP-OSATS).

METHODS: This study was conducted in two phases. Phase I included the development of PVP-OSATS and assessment of its reliability and construct validity. Panel discussion among experts led to the development of the PVP-OSATS tool with 12 parameters, each scored from 1 (worst) to 5 (best) with a maximum score of 60. Laser prostatectomy experts and PGTs from postgraduate years (PGY) 4 and 5 were recruited. Inter-rater reliability, using Cohen's and Fleiss's kappa, was calculated for all parameters. To assess for construct validity, PGTs were compared with experts. Phase II included assessment of the concurrent validity of this novel tool. This was performed by recruiting Quebec urology PGTs between PGY-3 and -5 to test their PVP skills during the semiannual objective structured clinical examination using the validated GreenLight(™) simulator.

RESULTS: During phase I,116 intraoperative PVP-OSATS assessments were collected; 102 for PGTs and 14 for experts. Cohen's and Fleiss's kappa was adequate (k ≥ 0.6) for all 12 parameters, confirming adequate inter-rater reliability. There was significant difference between PGTs and experts in all PVP-OSATS parameters (p ≤ 0.01) except in respect to anatomical landmarks and instrument damage. During phase II, there was significant positive correlation between PVP-OSATS scores inside the operating room and global scores obtained by the GreenLight simulator (r = 0.814; p < 0.001).

CONCLUSION: This study reports inter-rater reliability, construct, and concurrent validity of PVP-OSATS as a novel PVP-specific objective assessment tool.