Imperial College London
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Mr Daniel Richard Leff

Faculty of Medicine, Department of Surgery & Cancer

Reader in Breast Surgery
 
 
 
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Contact

 

d.leff Website

 
 
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Location

 

016Paterson WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Muthuswamy:2020:10.1097/SLA.0000000000003946,
author = {Muthuswamy, K and Fisher, R and Mavroveli, S and Petrou, F and Khawar, S and Amlani, A and Hanna, GB and Hadjiminas, D and Thiruchelvam, P and Leff, D},
doi = {10.1097/SLA.0000000000003946},
journal = {Annals of Surgery},
title = {Assessment of technical skills in axillary lymph node dissection},
url = {http://dx.doi.org/10.1097/SLA.0000000000003946},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Objective A simulator to enable safe practice and assessment of ALND has been designed, and face, content and construct validity has been investigated.Summary and Background Data  The  reduction  in  the  number  of  ALNDs  conducted  has  led  to  decreased  resident  exposure  and confidence. MethodsA cross-sectional multi-center observational study was carried out between July 2017 to August 2018.  Following  model  development,  30  surgeons  ofvarying experience (n=9 ‘experts’, n=11 ‘senior residents’ and n=10 ‘junior residents’) were asked to perform a simulated ALND. Face and content validity questionnaires were administered immediately after ALND. All ALND procedures were  retrospectively  assessed  by  two  attending  breast  surgeons,  blinded  to  operator  identity, using a video-based assessment tool and an end product assessment tool.ResultsStatistically  significant  differences  between  groups  were  observed  across  all  operative  sub-phases  on  theaxillary  clearance  assessment  tool  (p<0.001). Significant  differences  between groups were observed for overall procedure quality (p<0.05) and total number of lymph nodes harvested  (p<0.001).  However,  operator  grade  could  not  be  distinguished  across  other  end product  variables  such  as  axillary  vein  damage  (p=0.864)  and  long  thoracic  nerve  injury R1 ALND Structured abstract(p=0.094). Overall, participants indicated that the simulator has good anatomical (median score >7) and procedural realism (median score >7).ConclusionsVideo based analysis demonstrates construct validity for ALND assessment. Given reduced ALND exposure,  this  simulation  is  a  useful  adjunct  for  both  technical  skills  training  and  formative Deanery orFaculty administered assessments.
AU  - Muthuswamy,K
AU  - Fisher,R
AU  - Mavroveli,S
AU  - Petrou,F
AU  - Khawar,S
AU  - Amlani,A
AU  - Hanna,GB
AU  - Hadjiminas,D
AU  - Thiruchelvam,P
AU  - Leff,D
DO  - 10.1097/SLA.0000000000003946
PY  - 2020///
SN  - 0003-4932
TI  - Assessment of technical skills in axillary lymph node dissection
T2  - Annals of Surgery
UR  - http://dx.doi.org/10.1097/SLA.0000000000003946
UR  - https://journals.lww.com/annalsofsurgery/Abstract/9000/Assessment_of_Technical_Skills_in_Axillary_Lymph.94399.aspx
UR  - http://hdl.handle.net/10044/1/79233
ER  -
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