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Performance Assessment

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Comprehensive Healthcare Simulation: Surgery and Surgical Subspecialties

Part of the book series: Comprehensive Healthcare Simulation ((CHS))

Abstract

The skill of the surgeon directly impacts patient outcomes (Birkmeyer et al. N Engl J Med 369:1434–1442, 2013). This is intuitive, especially for a highly technical profession, yet our education and maintenance of certification (MOC) processes rarely incorporate standard objective performance assessment. In the education realm, surgical trainee advancement relies heavily on the consolidation of subjective faculty feedback. The Accredited Council of Graduate Medical Education (ACGME) and the Residency Review Committees (RRCs) for individual specialty-specific programs utilize the ACGME Milestones including assessment of six core competencies which encompass technical, cognitive, and communication skills yet remain relatively subjective measures of performance (Nasca et al. New Engl J 366:1051–1056, 2012). MOC algorithms for practicing surgeons still rely heavily on cognitive multiple choice tests and self-paced continuing medical education (CME) endeavors and have not yet embraced procedural skills assessment for concern over logistics and standardization.

In this chapter we will discuss the objective methods available for performance assessment of learning and practicing surgeons. We will first focus on the need for objective skills assessment in our profession followed by some definitions and decomposition of surgical skill. We will then discuss how objective skills metrics are being used today and where we should apply objective assessment methods going forward. We will close with the methods for accomplishing objective assessments. This chapter should provide any educator, instructor, graduate medical education administrator, or professional board member with knowledge on opportunities for objective performance assessment of surgical clinicians.

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Authors and Affiliations

  1. Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, USA

    Timothy M. Kowalewski

  2. Department of Urology, University of Washington, Seattle Children’s Hospital, Seattle, WA, USA

    Thomas S. Lendvay

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  1. Timothy M. Kowalewski
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  2. Thomas S. Lendvay
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Correspondence to Timothy M. Kowalewski .

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Editors and Affiliations

  1. Vice Chair of Education, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA

    Dimitrios Stefanidis

  2. Vice Chair of Education, Department of Surgery, Stanford University, Stanford, CA, USA

    James R. Korndorffer Jr.

  3. Executive Director WISH and CREST, Department of Urology, University of Washington, Seattle, WA, USA

    Robert Sweet

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Kowalewski, T.M., Lendvay, T.S. (2019). Performance Assessment. In: Stefanidis, D., Korndorffer Jr., J., Sweet, R. (eds) Comprehensive Healthcare Simulation: Surgery and Surgical Subspecialties. Comprehensive Healthcare Simulation. Springer, Cham. https://doi.org/10.1007/978-3-319-98276-2_9

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