THE DEVELOPMENT AND VALIDATION OF THE LUMBAR MICRODISCECTOMY ASSESSMENT SCALE

Abstract

Lumbar microdiscectomy (LM) is the index spinal surgical operation for neurosurgery and orthopaedic surgery trainees. Surgical training has moved towards competency-based training, yet there is no objective competency-based assessment tool for LM. In this thesis, we reviewed the literature on educational tools in spinal surgery. While we identified a number of models with which to educate spinal surgery trainees, at this stage, there are no procedure-specific assessment tools in spinal surgery. In order to develop an objective evaluation tool for assessment of LM, the procedure was broken down into its composite steps using a hierarchical task analysis. We then performed a Delphi analysis with both international and local neurosurgeons working in teaching hospitals to reach expert consensus on the lumbar microdiscectomy assessment scale (LMAS). Finally, to ensure reliability and validity of the tool, we used the LMAS to assess the video recordings of eight expert and eight novice performance of LM. We were able to demonstrate that the LMAS is a valid and reliable tool for assessing performance of LM surgery.