Construção e validação do SAMBA: novo método avaliativo de habilidades microcirúrgicas de aneurisma não roto da artéria cerebral média

Detalhes bibliográficos
Ano de defesa: 2017
Autor(a) principal: Taise Miriam Cruz Mosso Ramos
Orientador(a): Não Informado pela instituição
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal de Minas Gerais
UFMG
Programa de Pós-Graduação: Não Informado pela instituição
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Link de acesso: http://hdl.handle.net/1843/FRSS-BB6LE4
Resumo: Introduction: Surgical performance evaluation was first described with OSATS and modified for aneurysm microsurgery simulation by OSAACS. These methods rely in subjective evaluator´s opinion therefore an objective evaluation of proficiency in microsurgery of brain aneurysm has not been reported. Objective: The objective of this study is to describe and validate a score of skills acquisition assessment for microsurgery of brain aneurysm (SAMBA) that can be used similarly in a simulator and in middle cerebral artery non-ruptured aneurysm. Methods: SAMBA was developed and validated though face, inter-rater and testretest reliability using 4 experts, 4 intermediates and 4 beginners performing nonruptured MCA aneurysm microsurgery and ex vivo brain aneurysm surgical simulation. Results: SAMBA results were confronted using descriptive statistics, Croncbach´s alpha indexes and MANOVA analyses (p<0.05). SAMBA results showed that experts, intermediates and novices scored, respectively, an average of 33.9, 27.1 and 16.4 points in real surgery, and 33.4, 27.3 and 19.4 points in simulator. SAMBA inter-rater reliability index for real surgery and simulated surgery were 0.995 and 0.996; intra-rater reliability was 0.983 (Cronbach´s alpha). Averagepoints among expert, intermediate and novice were different in aneurysmmicrosurgery and in simulator (p<0.001). Novice scores were more diverse. Conclusion: Placenta brain aneurysm simulator has been predictive validated, but SAMBA adds to it an objective scoring system to verify microsurgical ability in this complex operation, stratifying by points the proficiency level. SAMBA can be used as an interface between learning and practicing as is can be applied in a safe and controlled environment, such as simulator, with similar results obtained in real surgery.Key Words: Aneurysm; Simulation; Placenta; Evaluation; Craving; Efficiency.