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Table 2 Overview of studies identified for inclusion

From: Tools for measuring technical skills during gynaecologic surgery: a scoping review

Author and year Assessment tool Study design and assessment method Domains assessed
Hiemstra et al. [17]
Objective Structured Assessment of Technical Skills
Observational study
Self-assessment and peri- and postoperative assessment by supervisor
Generic scale
1) Respect for tissue 2) Time and motion 3) Knowledge and handling of instrument 4) Flow of operation 5) Use of assistants 6) Knowledge of specific procedure
Chen et al. [18]
Vaginal Surgical Skills Index
Observational study
Assessment by supervisor and blinded reviewer of video recording
Generic and procedure-specific scale
1) Initial inspection 2) Incision 3) Maintenance of visibility 4) Use of assistants 5) Knowledge of instruments 6) Tissue and instrument handling 7) Electro surgery 8) Knot tying 9) Haemostasis 10) Procedure completion 11) Time and motion 12) Flow of operation and forward planning 13) Knowledge of specific procedure
Chou B et al. [19]
Hopkins Assessment of Surgical Competency
Observational study
Self-assessment and assessment by supervisor
Generic and procedure-specific scale
General surgical skills: 1) Knowledge/avoidance of potential complications, 2) Respected tissue, 3) Instrument Handling, 4) Time and motion/moves not wasted, 5) Bleeding controlled, 6) Flow of operation
Specific surgical skills: 1) Knowledge of patient history/surgical indication, 2) Knowledge of anatomy, 3) Patient properly positioned on table/in stirrups, 4) Proper placement of retractors, 5) Proper assembly equipment, 6) Proper positioning of lights
Larsen CR et al. [20]
Objective Structured Assessment of Laparoscopic Salpingectomy
Prospective cohort study
Blinded video assessment by two observers
Generic and procedure-specific scale
OSALS general skills 1) Economy of movement, 2) Confidence of movement, 3) Economy of time, 4) Errors; respect for tissue, 5) Flow of operation/operative technique
OSALS specific skills: 1) Presentation of anatomy, 2) Use of diathermy, 3) Dissection of fallopian tube, 4) Care for ovary, ovarian artery and pelvic wall, 5) Extraction of fallopian tube
Peter J. Frederick et al. [21]
Robot Hysterectomy Assessment Score
Observational study
Blinded video assessment by expert reviewers
Procedure-specific scale
1) Handling of the round ligament, 2) Developing the bladder flap, 3) Isolating and securing the infundibulopelvic ligament (or utero-ovarian ligament if the ovaries were retained), 4) Securing the uterine vessels, 5) Performing the colpotomy and 6) Closing the vaginal cuff
Jeanne Goderstad et al. [22]
Competence Assessment for Laparoscopic Supracervical Hysterectomy
Prospective interobserver study
Blinded video assessment by expert reviewers
Procedure-specific scale
1) Ligament mobilisation, 2) Release of adnexa form uterus, 3) Division of uterine vessels, 4) Uterus amputation
Savran et al. [23]
Feasible rating scale for formative and summative feedback Prospective cohort study
Blinded video assessment by two observers
Procedure-specific scale
1) Division of fallopian tube and uteroovarian OR division of the infundibulopelvix ligament 2) Dividing the round ligament 3) Care for the ureter 4) Opening the utero-vesicale peritoneum 5) Identification and skeletonising 6) Presentation and ligation of uterine arteries 7) Opening of the vagina 8) Suturing (catching the needle) 9) Driving the needle through tissue, 10) Placement and depth of sutures in the vaginal cuff, 11) Suturing of the vagina and tying the knot
Heinrich Husslein et al. [24]
Generic Error Rating Tool
Prospective observational study
Blinded video assessment by expert reviewers
Error assessment - generic and procedure-specific scale
1) Abdominal access and removal of instruments or trocars, 2) Use of retractors, 3) Use of energy, 4) Grasping and dissection, 5) Cutting, transection and stapling, 6) Clipping, 7) Suturing, 8) Use of suction, 9) Other
Each generic task subdivided into four distinct error modes: (1) Too much use of force or distance, 2) Too little use of force or distance, 3) Inadequate visualisation, 4) Wrong orientation of instrument
Procedure subdivided into: 1) Insertion of trocars, 2) Creation of bladder flap, 3) Colpotomy 4) Vault closure