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The Journal of Cardiovascular Surgery 2010 April;51(2):253-6

Copyright © 2010 EDIZIONI MINERVA MEDICA

language: English

Validation of the Simulator for Testing and Rating Endovascular SkillS (STRESS)-machine in a setting of competence testing

Berger P. 1, Willems M. C. M. 1, Van Der Vliet J. A. 1, Schultze Kool L. J. 2, Bergqvist D. 3, Blankensteijn J. D. 1, 4

1 Department of Surgery, Division of Vascular Surgery, Radboud University Nijmegen Medical Centre, Nijmegen the Netherlands; 2 Department of Interventional Radiology, Radboud University Nijmegen Medical Centre, Nijmegen the Netherlands; 3 Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University Hospital, Uppsala, Sweden; 4 Department of Surgery, Division of Vascular Surgery, VU Medical Center, Amsterdam, the Netherlands


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AIM: Endovascular skills are an integral part of modern-day vascular surgery. The STRESS machine has been developed to test these skills in vascular surgeons. This study aims to define an optimal pass/fail cutoff value for the STRESS test score.
METHODS: The STRESS machine consists of a dry glass model of the abdominal aorta and its tributaries with various stenotic lesions, elongations, and tortuosities. A camera and computer software are used to simulate plain fluoroscopy-mode. The test subjects are given two assignments after which two reviewers use a combination of the ICEPS and MRS to produce the final total score; 43 subjects were tested. According to previous endovascular experience, subjects were classified into four groups: novice-low (no experience, less than 11 performed procedures, less than 50 assisted procedures), novice-high (11-25 performed procedures, more than 50 assisted procedures), intermediate (1-10 performed and >11-25 assisted procedures, 11-25 performed and >1-10 assisted procedures or 25-50 performed procedures) and advanced (more than 50 performed procedures).
RESULTS: Test-score and noted experience showed a correlation of 0.794. All intermediate and advanced test subjects scored more than 50 points compared to 4 out of 15 novices.
CONCLUSION: We demonstrated that it is possible to determine an optimal cut-off value for competence testing with the STRESS machine.

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p.berger@chir.umcn.nl