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Validity and Reliability of the Robotic Objective Structured Assessment of Technical Skills

Siddiqui, Nazema Y. MD, MHSc; Galloway, Michael L. DO; Geller, Elizabeth J. MD; Green, Isabel C. MD; Hur, Hye-Chun MD; Langston, Kyle PA; Pitter, Michael C. MD; Tarr, Megan E. MD, MS; Martino, Martin A. MD

doi: 10.1097/AOG.0000000000000288
Contents: Original Research

OBJECTIVE: Objective Structured Assessments of Technical Skills have been developed to measure the skill of surgical trainees. Our aim was to develop an Objective Structured Assessments of Technical Skills specifically for trainees learning robotic surgery.

METHODS: This is a multiinstitutional study conducted in eight academic training programs. We created an assessment form to evaluate robotic surgical skill through five inanimate exercises. Gynecology, general surgery, and urology residents, Fellows, and faculty completed five robotic exercises on a standard training model. Study sessions were recorded and randomly assigned to three blinded judges who scored performance using the assessment form. Construct validity was evaluated by comparing scores between participants with different levels of surgical experience; interrater and intrarater reliability were also assessed.

RESULTS: We evaluated 83 residents, nine Fellows, and 13 faculty totaling 105 participants; 88 (84%) were from gynecology. Our assessment form demonstrated construct validity with faculty and Fellows performing significantly better than residents (mean scores 89±8 faculty, 74±17 Fellows, 59±22 residents; P<.01). In addition, participants with more robotic console experience scored significantly higher than those with fewer prior console surgeries (P<.01). Robotic Objective Structured Assessments of Technical Skills demonstrated good interrater reliability across all five drills (mean Cronbach's α 0.79±0.02). Intrarater reliability was also high (mean Spearman's correlation 0.91±0.11).

CONCLUSION: We developed a valid and reliable assessment form for robotic surgical skill. When paired with standardized robotic skill drills, this form may be useful to distinguish between levels of trainee performance.


An assessment form for robotic surgical skill that demonstrates construct validity and interrater and intrarater reliability may be useful to distinguish between levels of trainee performance.Supplemental Digital Content is Available in the Text.

Departments of Obstetrics and Gynecology, Duke University, Durham, North Carolina; Wright State University, Dayton, Ohio, the University of North Carolina, Chapel Hill, North Carolina; Johns Hopkins University, Baltimore, Maryland; Beth Israel Deaconess Medical Center, Boston, Massachusetts; Lehigh Valley Health Network, Allentown, Pennsylvania; Newark Beth Israel Medical Center, Newark, New Jersey; and Cleveland Clinic, Cleveland, Ohio.

Corresponding author: Nazema Y. Siddiqui, MD, MHSc, Duke University Medical Center, DUMC 3192, Durham, NC 27710; e-mail:

Supported by the National Center For Advancing Translational Sciences under award number UL1TR001117. Dr Siddiqui is supported by award number K12-DK100024 from the National Institute of Diabetes and Digestive and Kidney Diseases.

The authors thank Grace Fulton, BS (research coordinator), Duke University Medical Center, for study coordination; Samantha Thomas, MB, Duke University, for assistance with statistical analyses; and Jon Kost and Hubert Huang, Lehigh Valley Health Network, for assistance with video editing and data coordination.

Presented at the 2013 APGO/CREOG Meeting, February 27–March 2, 2013, Phoenix, Arizona.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Financial Disclosure All authors received reimbursement for travel from Intuitive Surgical, Inc., for a total of three curriculum development/research meetings. Dr. Pitter is a paid consultant for Intuitive Surgical, Inc; Dr. Geller has received speaking honoraria.

© 2014 by The American College of Obstetricians and Gynecologists.