Face, Content, and Construct Validity of an Aneurysm Clipping Model Using Human Placenta.

Abstract

Proficient open surgical treatment of cerebral aneurysms requires extensive training and practice. This study tested the validity of a human placenta aneurysm model for surgical simulation training of aneurysm clipping. There were 30 participants divided into 3 groups (n = 10 per group) according to their neurosurgical experience: low experience, intermediate experience, and attending. Subjective measures were collected using the Aneurysm Clipping Participant Survey (n = 27). Objective measures were collected by observing the participants (n = 30) work through a series of aneurysm clipping tasks while 2 independent raters evaluated them using a newly developed standardized tool, the Objective Structured Assessment of Aneurysm Clipping Skills. In terms of the subjective measures of face validity, most of the attending group (7/10; 70%) rated the models as "somewhat" to "very well" replicating real surgery. Content validity assessment of the model showed that it could improve the following skills: microdissection technique (27/27; 100%), use of clip appliers for aneurysm clipping (27/27; 100%), and surgical technique when applied to patients (25/27; 93%). The objective measure for construct validity demonstrated that mean Objective Structured Assessment of Aneurysm Clipping Skills scores between the 3 groups (low-experience group, 22.9 ± 5.4; intermediate-experience group, 32.8 ± 4.0; attending group, 43.3 ± 1.3) differed significantly (P < 0.001). The human placenta aneurysm clipping model is a useful training tool for teaching residents, with evidence of internal consistency and face, content, and construct validities. The Objective Structured Assessment of Aneurysm Clipping Skills scale is a feasible tool to assess aneurysm clipping skills quantitatively.