The Montreal Augmentation Mammoplasty Operation (MAMO) Simulator: An Alternative Method to Train and Assess Competence in Breast Augmentation Procedures

Abstract

Background

Surgical residents' exposure to aesthetic procedures remains limited in residency training. The development of the Montreal Augmentation Mammoplasty Operation (MAMO) simulator aims to provide an adjunctive training method and assessment tool to complement the evolving competency-based surgical curriculum.

Objectives

To perform face, content and construct validations of the MAMO simulator for subpectoral breast augmentation procedures and assess the reliability of the assessment scales used.

Methods

Plastic surgery staff and residents were recruited to perform a subpectoral breast augmentation on the simulator. Video recordings of their performance were blindly evaluated using the Objective Structured Assessment of Technical Skills (OSATS) system consisting of the Global Rating Scale (GRS), Mammoplasty Objective Assessment Tool (MOAT) and a surgery-specific Checklist score.

Results

Fourteen plastic surgery residents and seven expert plastic surgeons were enrolled. Experts' performance was significantly higher than residents' according to each of GRS, MOAT and Checklist scores. Mean values of residents and experts were 23.4 (2.5) vs. 36.9 (3.1) (p<0.0001) for GRS score, 30.4 (2.2) vs. 40 (3.2) (p<0.0001) for MOAT scores and 9.7 (1.5) vs. 12 (1) (p<0.001) for Checklist scores, respectively. Face and content validations showed excellent results among parameters evaluated, with an overall mean score of 4.8 (0.3) on 5. Cronbach's alpha was 0.96 and 0.83 for GRS and MOAT scores, respectively. Intraclass Correlation Coefficients for interrater reliability were excellent at 0.93, 0.92, and 0.89 for the GRS, MOAT, and Checklist scores, respectively.

Conclusions

This study proves the construct simulator to be valid and the assessment scales to be reliable.