Origami Box Folding Exercise: A laparoscopic box simulation training and assessment method in facilitating laparoscopic psychomotor skills with minimal preparation

Hsin-Hong Kuo; Chih-Feng Yen; Hung-Hsueh Chou; Wei-Li Lin; Kuan-Gen Huang; Chyi-Long Lee; Kung-Liahng Wang; Ming-Ju Hsieh

doi:10.1016/j.tjog.2022.08.015

Origami Box Folding Exercise: A laparoscopic box simulation training and assessment method in facilitating laparoscopic psychomotor skills with minimal preparation

Taiwan J Obstet Gynecol. 2023 Jan;62(1):31-39. doi: 10.1016/j.tjog.2022.08.015.

Authors

Hsin-Hong Kuo¹, Chih-Feng Yen², Hung-Hsueh Chou², Wei-Li Lin¹, Kuan-Gen Huang², Chyi-Long Lee², Kung-Liahng Wang³, Ming-Ju Hsieh⁴

Affiliations

¹ Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan.
² Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Department of Obstetrics and Gynecology, Taitung MacKay Memorial Hospital, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
⁴ College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taiwan. Electronic address: hsiehmj2@gmail.com.

PMID: 36720546
DOI: 10.1016/j.tjog.2022.08.015

Abstract

Objective: Laparoscopic box simulation training is widely recognized as an assessment tool to facilitate psychomotor skills especially for novice surgeons. However, current commercialized training modules including pegs, gauze, clips, pins etc. are generally costly and relatively inaccessible. We introduce a simple and pioneer surgical training drill, the Origami Box Folding Exercise (OBFE), based on the validated evaluating system of objective structured assessment of technical skills (OSATS) constructed with the scoring system of procedure-specific checklist (PSC) and global rating scale (GRS).

Materials and methods: Face and content validation of the OBFE and OSATS are evaluated by five endoscopic experts from two medical centers in Taiwan. This is a prospective observational study analyzing the pre-test/post-test result of OBFE from 37 participants in two individual workshops as training and evaluating method for laparoscopic psychomotor skills. Both the pre and post tests are video recorded with a time limit of 5 min graded by two independent evaluators based on the OSATS scoring system.

Results: The reliability of PSC, GRS, and intergroup value between PSC and GRS were 0.923, 0.926 and 0.933, respectively. Inter-rater reliability of PSC, GRS, and both were 0.985, 0.932 and 0.977, respectively. Construct validity of PSC and GRS were statistically significant, with p-value 0.006 and 0.001, respectively.

Conclusion: OBFE enhances laparoscopic psychomotor skills with requirement of a single piece of paper. The associated OSATS tool for a 5-min OBFE test was validated. OBFE training is an efficient training and assessment system to promote psychomotor skills in laparoscopic box simulation drill which requires simple and economical preparation.

Keywords: Hand-eye coordination; K-Box; Objective structured assessment of technical skills (OSATS); Paper folding; Simulator.

Publication types

Observational Study

MeSH terms

Humans
Internship and Residency*
Laparoscopy* / methods
Prospective Studies
Reproducibility of Results
Simulation Training* / methods