Development of the “LAser Surgical skills Evaluation for Residents” (LASER) Scale Through a Modified Delphi Method

Background The CO2 laser is frequently used during microlaryngeal surgery (MLS) for a variety of pathology including laryngeal malignancy and stenosis. Learning how to use the laser safely is part of the curriculum for every otolaryngology resident. However, assessment of laryngoscopy technical skills can be challenging for supervisors, making it difficult to adequately provide feedback to trainees. Objectives “LAser Surgical skills Evaluation for Residents” (LASER) Scale aims to facilitate the evaluation of residents’ performance and promote constructive feedback. Methods The initial evaluation grid was based on a literature review of CO2 laser laryngoscopy (with an emphasis on indications, technique, safety, and efficacy) using Covidence systematic review software (Veritas Health Innovation). The final version was produced after 4 rounds of Delphi surveys. Results This study was an international collaboration including 15 otolaryngologists with either laryngology or head and neck surgery subspecialties. Panelists were based in Canada (8), the United States (3), France (1), Spain (1), Belgium (1), and Lebanon (1). The process involved 4 rounds of Delphi surveys. Assessment categories included: anesthesia considerations, pre- and perioperative laser safety measures, and surgical technique. Consensus was reached on final survey completion. Conclusions Through a modified Delphi method, a novel scale was developed through an international collaborative effort that evaluates resident skillset in CO2 laser MLS. Future studies are warranted to validate this assessment tool. Graphical abstract