Validation of a Newly Developed Competency Assessment Tool for the Posterior Sagittal Anorectoplasty

Eur J Pediatr Surg. 2022 Oct;32(5):399-407. doi: 10.1055/s-0041-1736387. Epub 2021 Nov 25.

Abstract

Introduction: The correction of an anorectal malformation (ARM) is complex and relatively infrequent. Simulation training and subsequent assessment may result in better clinical outcomes. Assessment can be done using a competency assessment tool (CAT). This study aims to develop and validate a CAT for the posterior sagittal anorectoplasty (PSARP) on a simulation model.

Materials and methods: The CAT-PSARP was developed after consultation with experts in the field. The PSARP was divided into five steps, while tissue and instrument handling were scored separately. Participants of pediatric colorectal hands-on courses in 2019 and 2020 were asked to participate. They performed one PSARP procedure on an ARM simulation model, while being assessed by two objective observers using the CAT-PSARP.

Results: A total of 82 participants were enrolled. A fair interobserver agreement was found for general skills (intraclass correlation coefficient [ICC] = 0.524, p < 0.001), a good agreement for specific skills (ICC = 0.646, p < 0.001), and overall performance (ICC = 0.669, p < 0.001). The experienced group scored higher on all steps (p < 0.001), except for "anoplasty (p = 0.540)," compared with an inexperienced group.

Conclusion: The CAT-PSARP is a suitable objective assessment tool for the overall performance of the included steps of the PSARP for repair of an ARM on a simulation model.

MeSH terms

  • Anal Canal / abnormalities
  • Anal Canal / surgery
  • Anorectal Malformations* / surgery
  • Digestive System Surgical Procedures* / methods
  • Humans
  • Plastic Surgery Procedures* / methods
  • Rectum / abnormalities
  • Rectum / surgery
  • Treatment Outcome