Development of an electrosurgery-compatible simulation task for quantitatively assessing oral cancer resection skills: initial validity evidence

BACKGROUND: The quality of oral cancer resection is extremely important for patient outcomes, such as local control and survival. However, most current simulators either provide only rater-dependent feedback or are not compatible with electrosurgery. Therefore, we developed an electrosurgical simulation task for oral cancer resection that provides objective quantitative metrics and collected initial validity evidence. METHODS: We developed a soft tissue simulation task using a plant-derived model that supports electrosurgery. As quantitative measures demonstrating "ensuring appropriate margins" in oral cancer resection and "maintaining safety" during electrosurgery, we employed nine-directional margin error distance and tumor bed carbonization degree measured using a spectral colorimeter. As validity evidence of the task, 10 expert surgeons completed a questionnaire about the task. In addition, five experts and 12 novices performed the task, and quantitative data obtained from their performance was used for evaluation. RESULTS: The replication of oral cancer resection was highly evaluated (4.4 out of 5 points), and quantitative measures for evaluating the skills of surgeons (4.8 out of 5 points) were agreed upon by experts. The internal consistency of the measures was good (Cronbach's alpha: 0.803). Compared to novices, experts had smaller margin errors (0.79 mm vs 2.45 mm), lower carbonization (ΔE: 2.33 vs 8.70), faster resection times, and fewer grasping attempts (all P < 0.001). CONCLUSION: This user-friendly plant-derived simulation task is compatible with electrosurgery and provides objective quantitative performance metrics. These findings support its use as a practical assessment tool for formative feedback in simulation-based training.