Development of an objective evaluation tool to assess technical skill in laparoscopic colorectal surgery: a Delphi methodology

BACKGROUND: Laparoscopic colorectal surgery (LCS) is an advanced procedure for which no objective tools exist to assess technical skill. The aim of this study was to determine expert consensus regarding items required on a rating scale for LCS, using a Delphi technique. METHODS: Experts rated the substeps of LCS from 1 to 5. Responses were returned to the panel until consensus (Cronbach's alpha >= .80) was reached. Substeps that 80% of experts rated as >= 4 were included in the final instrument. RESULTS: Initially, alpha values were .81 for sigmoid colectomy, .77 for right (medial-to-lateral) colectomy, and .74 for the lateral-to-medial approach. In the second round, alpha values were .83 for medial-to-lateral right colectomy and .82 for lateral-to-medial colectomy. CONCLUSIONS: The Delphi method allowed the determination of consensus regarding the essential steps to be included in a tool designed to measure technical competence in LCS. (C) 2011 Elsevier Inc. All rights reserved.