Towards development and validation of an intraoperative assessment tool for robot-assisted radical prostatectomy training: results of a Delphi study

Vol. 43 (4): 661-670, July – August, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0420


Christopher Morris 1, Jen Hoogenes 1, Bobby Shayegan 1, Edward D. Matsumoto 1
1 Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada


Introduction: As urology training shifts toward competency-based frameworks, the need for tools for high stakes assessment of trainees is crucial. Validated assessment metrics are lacking for many robot-assisted radical prostatectomy (RARP). As it is quickly becoming the gold standard for treatment of localized prostate cancer, the development and validation of a RARP assessment tool for training is timely.

Materials and methods: We recruited 13 expert RARP surgeons from the United States and Canada to serve as our Delphi panel. Using an initial inventory developed via a modified Delphi process with urology residents, fellows, and staff at our institution, panelists iteratively rated each step and sub-step on a 5-point Likert scale of agreement for inclusion in the final assessment tool. Qualitative feedback was elicited for each item to determine proper step placement, wording, and suggestions.

Results: Panelist’s responses were compiled and the inventory was edited through three iterations, after which 100% consensus was achieved. The initial inventory steps were decreased by 13% and a skip pattern was incorporated. The final RARP stepwise in­ventory was comprised of 13 critical steps with 52 sub-steps. There was no attrition throughout the Delphi process.

Conclusions: Our Delphi study resulted in a comprehensive inventory of intraoperative RARP steps with excellent consensus. This final inventory will be used to develop a valid and psychometrically sound intraoperative assessment tool for use during RARP training and evaluation, with the aim of increasing competency of all trainees.

Keywords:  Delphi Technique; Prostatectomy; Robotic Surgical Procedures

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