Conceptualising Surgical Education Assessment

Abstract

The principles of surgical assessment do not differ much from assessment of medical competence in general. Purposes of surgical assessment include not only decision making about the level of the trainee surgeons, but also, in a training setting, steering learning behaviour. Reproducibility or reliability of the assessment results, validity of the methods, their educational impact, cost efficiency and acceptability/feasibility are all important concepts to be considered when designing or changing an assessment programme. The robust research findings that the content of the assignments (and not their format) is important for validity and that good sampling across contents and possible sources of error is more important for reliability than trying to make the assessment objective have given rise to a whole new set of observation-based assessment formats for the assessment of performance in practice. Some of the most important are described here. These must be seen as an addition rather than as a replacement of more theory-orientated forms. It is important to understand that where in theory-based assessment reliability and validity are built into the test paper, in practice-based assessment these qualities depend on the user. For practice-based assessment, good teacher training is, therefore, indispensible.