Assessment of competence in video-assisted thoracoscopic surgery lobectomy: A Danish nationwide study

Abstract Background Competence in VATS lobectomy has previously been established based on numbers of procedures performed but this approach does not ensure competence. Specific assessment tools like the newly developed VATSAT allow for structured and objective assessment of competence. Our aim was to provide validity evidence for VATSAT. Methods Video recordings of 60 VATS lobectomies performed by 18 thoracic surgeons were rated using the VATSAT. All four centers of thoracic surgery in Denmark participated in the study. Two VATS experts rated the videos. They were blinded to surgeon and center. Results The total internal consistency reliability, Cronbach's Alpha was 0.93. Inter-rater reliability between the two raters was Pearson's r=0.71 (p Conclusion Validity evidence was provided for a newly developed assessment tool for VATS lobectomy (VATSAT) in a clinical setting. The discriminatory ability between expert surgeons, intermediate surgeons, and beginners proved highly significant. VATSAT could be an important aid in the future training and certification of thoracic surgeons.