The Montreal augmentation mammoplasty operation (MAMO) simulator: A novel method of training and assessing competence in plastic surgery
Notice bibliographique
Résumé
Augmentation mammoplasty procedure remains the most commonly performed aesthetic procedure in plastic surgery. Residents’ training and technical skills assessment in this domain can prove to be challenging due to the limited access to private clinics where such procedures take place. An advanced simulation training environment can provide an alternative tool to train and assess residents’ performance, especially in the era of Competency-Based Education. The purpose of this project was to develop a simulator capable of replicating the essential steps of an augmentation mammoplasty procedure and achieve its face, content and construct validations.After identifying the essential surgical steps of the procedure using the modified Delphi methodology, a pilot project was undertaken to develop an early prototype part-task trainer in the aim of evaluating the silicone materials used. Following satisfactory realism scores achieved by the part-task trainer, the Montreal Augmentation Mammoplasty Operation (MAMO) simulator was developed using molding and casting techniques. All anatomical structures were replicated using adequate silicone material and alterations to the benchtop simulator were made to attain maximum reusability. This study design was a prospective blinded observational study. Plastic surgeons, both staff and residents, were recruited to perform a mammoplasty procedure on the simulator. Following an instructional video, participants completed the essential steps of the procedure and their performance was filmed. The expert surgeon participants evaluated the simulator’s various parameters and their overall experience. Video recordings of all participants’ performances were blindly reviewed and assessed using the Objective Structured Assessment of Technical Skills (OSATS) system: Global Rating Scale (GRS) score, Mammoplasty Objective Assessment Tool (MOAT) score and a Checklist score. Data was recorded as mean (SD).Twenty-one participants were enrolled in this study (14 residents and 7 experts). Mean values of residents and experts were 23.4 (2.5) vs 36.9 (3.1) (p<0.0001) for GRS score, 30.4 (2.2) vs 40 (3.2) (p<0.0001) for MOAT scores and 9.7 (1.5) vs 12 (1) (p<0.001) for Checklist scores respectively. Construct validation was achieved by the demonstrating significantly higher performance by experts with all the objective metric tools used. Face and content validations results showed excellent results among parameters evaluated, with an overall mean score of 4.8 (0.3) on 5. Cronbach’s alpha was 0.96 and 0.83 for GRS and MOAT scores respectively. Intraclass Correlation Coefficients for interrater reliability were excellent at 0.93, 0.92 and 0.89 for the total GRS, MOAT and Checklist scores respectively.This project demonstrated the validation of face, content and construct of the MAMO simulator. It also established the MAMO simulator system as the first Plastic Surgery-specific tool capable of consistently measuring residents’ performance and attributing competence in subpectoral mammoplasty procedures
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».