Vaginal Surgical Skills Index (VSSI)
Chen et al.17 introduced VSSI, which is a
procedure-specific rating scale for evaluating surgeons while performing
vaginal hysterectomies. VVSI is an expanded and modified form of the
original seven-item Global Rating Scale (GRS). 14 They
developed and adjusted GRS to contain items considered important for
vaginal surgery, 13 in total, including: initial inspection, performance
of an incision, maintenance of visibility, use of electro surgery, knot
tying, maintenance of haemostasis, removing fluid and debris, completion
of the procedure and forward planning.
Twenty-seven trainees performed 76 surgeries in the study period. The
operating surgeon was evaluated using VSSI as soon as the hysterectomy
was performed. VSSI was then compared with GRS scores and good construct
validity was found. The procedure was videotaped, and to assess
interrater reliability, a blinded reviewer evaluated the performing
surgeon using VSSI, GRS and a 100-mm visual analogue scale, which was
included as an additional measure to furnish the assessor with a global
impression of the trainees’ surgical skills.
To assess intrarater reliability, the supervising surgeon watched and
re-evaluated the video after four weeks. Internal consistency for VSSI
and GRS was high (Cronbach’s alpha=0.95-0-97). Using intraclass
correlation coefficient (ICC), the authors concluded that the VSSI
interrater reliability (ICC=0.53) and intrarater reliability (ICC=0.82)
were good.