Top

Published in:

01-07-2012

Can both residents and chief physicians assess surgical skills?

Authors: Jeanett Oestergaard, Christian Rifbjerg Larsen, Mathilde Maagaard, Teodor Grantcharov, Bent Ottesen, Jette Led Sorensen

Published in: Surgical Endoscopy | Issue 7/2012

Abstract

Background

It is known that structured assessment of an operation can provide trainees with useful knowledge and potentially shorten their learning curve. However, methods for objective assessment have not been widely adopted into the clinical setting. This might be because of a lack of expertise using an assessment tool. The aim of this present study was to investigate if a validated laparoscopic procedure-specific assessment tool could be used by doctors with different levels of experience.

Methods

The study was conducted as an observer-blinded, prospective cohort study. Three video recordings of a right-side laparoscopic salpingectomy were distributed to ten chief physicians, eight residents (fourth year trainees), and two expert assessors (all in gynecology) in order to be assessed using a validated procedure-specific assessment tool. The three salpingectomies were selected because they easily showed the different operational levels: novice, intermediate, and expert. The two expert assessors, i.e., our gold standard, were familiar with the OSA-LS assessment scale, but the chief physicians and the residents were not. All participants were blinded to the fact that surgeons with different experience had performed the salpingectomies.

Results

No significant differences between the residents and chief physicians were observed in any of the three assessed operations: novice, p = 0.63; intermediate, p = 0.93; and expert, p = 0.93. The chief physicians and residents matched our gold standard in assessing the intermediate operation (p = 0.177), but not the novice operation (p = 0.005) or the expert operation (p = 0.001).

Conclusions

Residents and chief physicians generated similar performance scores when assessing operations using a laparoscopic procedure-specific assessment scale, and they could distinguish performance levels between the surgeons. They matched the assessment score of our expert on the intermediate operation. We conclude that a procedure-specific assessment scale can be used by both residents and chief physicians when giving formative feedback.

Darzi A, Datta V, Mackay S (2001) The challenge of objective assessment of surgical skill. Am J Surg 181:484–486PubMedCrossRef

Rodriguez-Paz JM, Kennedy M, Salas E, Wu AW, Sexton JB, Hunt EA, Pronovost PJ (2009) Beyond “see one, do one, teach one”: toward a different training paradigm. Postgrad Med J 85:244–249PubMedCrossRef

van Hove PD, Tuijthof GJ, Verdaasdonk EG, Stassen LP, Dankelman J (2010) Objective assessment of technical surgical skills. Br J Surg 97:972–987PubMedCrossRef

Aggarwal R, Moorthy K, Darzi A (2004) Laparoscopic skills training and assessment. Br J Surg 91:1549–1558PubMedCrossRef

Moorthy K, Munz Y, Sarker SK, Darzi A (2003) Objective assessment of technical skills in surgery. BMJ 327:1032–1037PubMedCrossRef

Grantcharov TP, Schulze S, Kristiansen VB (2007) The impact of objective assessment and constructive feedback on improvement of laparoscopic performance in the operating room. Surg Endosc 21:2240–2243PubMedCrossRef

Larsen CR, Grantcharov T, Schouenborg L, Ottosen C, Soerensen JL, Ottesen B (2008) Objective assessment of surgical competence in gynaecological laparoscopy: development and validation of a procedure-specific rating scale. BJOG 115:908–916PubMedCrossRef

Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, Brown M (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273–278PubMedCrossRef

Reznick R, Regehr G, MacRae H, Martin J, McCulloch W (1997) Testing technical skill via an innovative “bench station” examination. Am J Surg 173:226–230PubMedCrossRef

10.

Ten Cate O (2009) AMEE Guide Supplements: peer-assisted learning: a planning and implementation framework. Guide supplement 30.5 – viewpoint. Med Teach 31:57–58PubMedCrossRef

11.

Streiner D, Norman GR (2008) Health measurement scales: a practical guide to their development and use, 4th edn. Oxford University Press, New York

12.

Miller GE (1990) The assessment of clinical skills/competence/performance. Acad Med 65:S63–S67PubMedCrossRef

13.

Wass V, Van der Vleuten C, Shatzer J, Jones R (2001) Assessment of clinical competence. Lancet 357:945–949PubMedCrossRef

14.

Scott DJ, Dunnington GL (2008) The new ACS/APDS skills curriculum: moving the learning curve out of the operating room. J Gastrointest Surg 12:213–221PubMedCrossRef

15.

Driscoll PJ, Paisley AM, Paterson-Brown S (2008) Video assessment of basic surgical trainees’ operative skills. Am J Surg 196:265–272PubMedCrossRef

16.

van Det MJ, Meijerink WJ, Hoff C, Middel LJ, Koopal SA, Pierie JP (2011) The learning effect of intraoperative video-enhanced surgical procedure training. Surg Endosc 25:2261–2267PubMedCrossRef

17.

Tavakol M, Mohagheghi MA, Dennick R (2008) Assessing the skills of surgical residents using simulation. J Surg Educ 65:77–83PubMedCrossRef

18.

Beard JD (2005) Setting standards for the assessment of operative competence. Eur J Vasc Endovasc Surg 30:215–218PubMedCrossRef

19.

Driscoll PJ, Paisley AM, Paterson-Brown S (2008) Video assessment of basic surgical trainees’ operative skills. Am J Surg 196:265–272PubMedCrossRef

20.

Beard JD, Jolly BC, Newble DI, Thomas WE, Donnelly J, Southgate LJ (2005) Assessing the technical skills of surgical trainees. Br J Surg 92:778–782PubMedCrossRef

21.

Backstein D, Agnidis Z, Sadhu R, MacRae H (2005) Effectiveness of repeated video feedback in the acquisition of a surgical technical skill. Can J Surg 48:195–200PubMed

22.

Jamshidi R, LaMasters T, Eisenberg D, Duh QY, Curet M (2009) Video self-assessment augments development of videoscopic suturing skill. J Am Coll Surg 209:622–625PubMedCrossRef

23.

Akl MN, Giles DL, Long JB, Magrina JF, Kho RM (2008) The efficacy of viewing an educational video as a method for the acquisition of basic laparoscopic suturing skills. J Minim Invasive Gynecol 15:410–413PubMedCrossRef

24.

Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondre K, Stanbridge D, Fried GM (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190:107–113PubMedCrossRef

Title: Can both residents and chief physicians assess surgical skills?
Authors: Jeanett Oestergaard
Christian Rifbjerg Larsen
Mathilde Maagaard
Teodor Grantcharov
Bent Ottesen
Jette Led Sorensen
Publication date: 01-07-2012
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 7/2012
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-012-2155-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Can both residents and chief physicians assess surgical skills?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2012

Perioperative polyphenon E- and siliphos-inhibited colorectal tumor growth and metastases without impairment of gastric or abdominal wound healing in mouse models

Hysteroscopic placement of tubal sterilization implants: virtual reality simulator training

Challenging a classic myth: pneumoperitoneum associated with acute diverticulitis is not an indication for open or laparoscopic emergency surgery in hemodynamically stable patients. A 10-year experience with a nonoperative treatment

Laparoscopic colorectal resection for cancer: effects of conversion on long-term oncologic outcomes

Laparoscopic surgery for rectal cancer: preoperative radiochemotherapy versus surgery alone

Laparoscopic extraperitoneal aortic dissection: does single-port surgery offer the same possibilities as conventional laparoscopy?