A novel tool for assessing psychomotor proficiency in laparoscopic cholecystectomy using simulation-based training

• DOI: 10.1007/s00464-025-11708-2
• Publication Date: 2025-04-18T15:15:46Z
• Authors: Erin Kim; Marius J. Tchinde; Deborah M. Rooney; Blessing N. Ngam; R. Luke Rettig; Christopher L. Gross; Mark J. Snell; Melanie L. Barnard; Kevin El-Hayek; David R. Jeffcoach; Grace J. Kim

Abstract Introduction Laparoscopy is underutilized in lower- and middle-income countries (LMICs) due to limited access training opportunities. Laparoscopic cholecystectomy the gold standard for treating gallbladder disease high-income (HICs), yet open approach predominates LMICs. A low-cost, simulation-based educational module teaching laparoscopic was developed by an international collaboration. novel tool verifying proficiency (CHOLE-VOP), incorporating a procedural checklist, global rating scale (GRS), final competency rating, designed piloted evaluate psychomotor skill acquisition cholecystectomy. Methods Fifty-two users completed learning module, submitted video recording of their performance on tool, performed self- peer-assessment videos using CHOLE-VOP. Kruskal–Wallis test used assess CHOLE-VOP’s ability differentiate across three experience levels [novice (no experience), intermediate (1–30 cases), expert (> 30 cases)] between settings (LMICs vs. HICs). Inter-rater agreement measured self-assessment peer-assessment, reviewer levels. Results Among [novices (14), intermediates (18), experts (17), unknown (3)], checklist scores significantly increased from novice ( M = 28.16) 31.33) 32.66), P < 0.001. Both GRS ratings effectively discriminated levels, LMIC had higher (32.41 29.35, 0.008) (17.54 15.14, 0.002). peer-assessments moderate (ICC 0.52), with poor novices 0.24), who tended overestimate performance, good 0.79). Conclusion The CHOLE-VOP successfully simulated module. outperformed HIC select parameters. Self-assessments, particularly among novices, showed concordance peer-assessments. Graphical abstract