Research in Focus:

Assessment of Technical Skills in Simulated Oncoplastic Wide Local Excision – Construct Validity of Procedure Specific Global Rating Scales

Authors: Daniel Leff, George Petrou, Stella Mavroveli, Daniel Cocker, Monika Bersihand, Rageed Al-Mufti, Ara Darzi, George Hana.

Year: 2014

Journal: European Journal of Surgical Oncology

DOI: https://doi.org/10.1016/j.ejso.2014.02.066

For our latest “Research in Focus” post, we will be exploring technical skills assessment for wide local excision using our original breast model ‘Lily’.

This study presents the initial validation of Lily, a high-fidelity oncoplastic breast simulator. Oncoplastic breast surgery is a specialty where the clinical training pathways does not always meet training needs, yet simulation has historically lagged behind. The aim was to investigate the validity of simulation for the technical skills assessment of wide local excision.

Twenty-nine surgeons (consultants = 5; specialty trainees = 14; core trainees = 10) performed a wide local excision on the breast simulator. Performances were blindly assessed through video review using procedure-specific rating scales and radiographic analysis.

Key Takeaways

  • Construct Validity Proven: The simulator and global rating scales successfully differentiated skill levels between surgeons.
  • Specimen Weight: Higher specimen weights trended with seniority, supporting use as a performance metric.
  • Margin Quality: Macroscopic margin assessment did not effectively discriminate between experience levels.
  • Challenges: Whilst demonstrating the simulator and assessment tool’s discriminatory ability, further work is needed to strengthen the body of evidence.

Relevance to SiMPEDIA

This study reinforces the critical role procedure-specific, validated simulators can play in specialties where clinical exposure is limited. Lily exemplifies SiMPEDIA’s commitment to evidence-based design, aligning innovation with the real-world training needs of our clients and surgical training pathways.

SiMPEDIA continues to support the surgical community with realistic, curriculum-aligned simulators that empower safe, structured learning and valid assessment.