World Journal of Surgery

, Volume 32, Issue 2, pp 156–160

Objective Assessment of Technical Performance

Article

Abstract

Technical skills are essential to the practice of surgery. They can be taught in the operating room and in the surgical skills laboratory. The use of simulators allows the development of reproducible curricula with measurement of performance using objective metrics. The goal of those designing metrics for the simulation laboratory should be to establish measures that are consistent with those of high quality surgery in the operating room. Once these metrics have been shown to be reliable, valid, practical to use, and meaningful to the learner, they can form the basis of a learning program based on the acquisition of proficiency. Performance in the skills laboratory should ultimately be predictive of performance in the clinical setting.

References

  1. 1.
    Moorthy K, Munz Y, Sarker SK, et al. (2003) Objective assessment of technical skills in surgery. BMJ 327:1032–1037PubMedCrossRefGoogle Scholar
  2. 2.
    Sidhu RS, Grober ED, Musselman LJ, et al. (2004) Assessing competency in surgery: where to begin? Surgery 135:6–20PubMedCrossRefGoogle Scholar
  3. 3.
    Scott DJ, Bergen PC, Rege RV, et al. (2000) Laparoscopic training on bench models: better and more cost effective than operating room experience? J Am Coll Surg 191:272–283PubMedCrossRefGoogle Scholar
  4. 4.
    Vassiliou MC, Feldman LS, Andrew CG, et al. (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190:107–113PubMedCrossRefGoogle Scholar
  5. 5.
    Scott DJ, Rege RV, Bergen PC, et al. (2000) Measuring operative performance after laparoscopic skills training: edited videotape versus direct observation. J Laparoendosc Adv Surg Tech A 10:183–190PubMedCrossRefGoogle Scholar
  6. 6.
    Derossis AM, Fried GM, Abrahamowicz M, et al. (1998) Development of a model for training and evaluation of laparoscopic skill. Am J Surg 175:482–487PubMedCrossRefGoogle Scholar
  7. 7.
    Bann SD, Khan MS, Darzi A (2003) Measurement of surgical dexterity using motion analysis of simple bench skills. World J Surg 27:390–394PubMedCrossRefGoogle Scholar
  8. 8.
    Brydges R, Classen R, Larmer J, et al. (2006) Computer-assisted assessment of one-handed knot tying skills performed within various contexts: a construct validity study. Am J Surg 192:109–113PubMedCrossRefGoogle Scholar
  9. 9.
    Martin JA, Regehr G, Reznick R, et al. (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273–278PubMedCrossRefGoogle Scholar
  10. 10.
    Datta V, Bann S, Mandalia M, et al. (2006) The surgical efficiency score: a feasible, reliable, and valid method of skills assessment. Am J Surg 192:372–378PubMedCrossRefGoogle Scholar
  11. 11.
    Vassiliou MC, Feldman LS, Andrew CG, et al. (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190:107–113PubMedCrossRefGoogle Scholar
  12. 12.
    Van Sickle KR, McClusky DA III, Gallagher AG, et al. (2005) Construct validation of the ProMIS simulator using a novel laparoscopic suturing task. Surg Endosc 19:1227–1231PubMedCrossRefGoogle Scholar
  13. 13.
    Fried GM, Feldman LS, Vassiliou MC, et al. (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–528PubMedCrossRefGoogle Scholar
  14. 14.
    Vassiliou MC, Ghitulescu GA, Feldman LS, et al. (2006) The MISTELS program to measure technical skill in laparoscopic surgery: evidence for reliability. Surg Endosc 20:744–747PubMedCrossRefGoogle Scholar
  15. 15.
    Streiner DL, Norman GR (1995) Health Measurement Scales: A Practical Guide to Their Development and Use. 2nd edition. Oxford, Oxford University PressGoogle Scholar
  16. 16.
    Cronbach LJ, Meehl PE (1955) Construct validity in psychological tests. Psychol Bull 52:281–302 PubMedCrossRefGoogle Scholar
  17. 17.
    Feldman LS, Hagarty SE, Ghitulescu G, et al. (2004) Relationship between objective assessment of technical skills and subjective in-training evaluations in surgical residents J Am Coll Surg 198:105–110PubMedCrossRefGoogle Scholar
  18. 18.
    Fried GM, Derossis AM, Bothwell J, et al. (1999) Comparison of laparoscopic performance in vivo with performance measured in a laparoscopic simulator. Surg Endosc 13:1077–1081 PubMedCrossRefGoogle Scholar
  19. 19.
    McCluney AL, Vassiliou MC, Stanbridge DD, et al. (2007, in press) FLS Simulator performance predicts intraoperative laparoscopic skill. Surg EndoscGoogle Scholar
  20. 20.
    Swanstrom LL, Fried GM, Hoffman KI, et al. (2006) Beta test results of a new system assessing competence in laparoscopic surgery. J Am Coll Surg 202:62–69PubMedCrossRefGoogle Scholar
  21. 21.
    Peters JH, Fried GM, Swanstrom LL, et al. (2004) Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 135:21–27PubMedCrossRefGoogle Scholar
  22. 22.
    Datta V, Bann S, Aggarwal R, et al. (2006) Technical skills examination for general surgical trainees. Br J Surg 93:1139–1146PubMedCrossRefGoogle Scholar
  23. 23.
    Derossis AM, Bothwell J, Sigman HH, et al. (1998) The effect of practice on performance in a laparoscopic simulator. Surg Endosc 12:1117–1120PubMedCrossRefGoogle Scholar
  24. 24.
    Derossis AM, Antoniuk M, Fried GM (1999) Evaluation of laparoscopic skills: a 2-year follow-up during residency training. Can J Surg 42:293–296PubMedGoogle Scholar
  25. 25.
    Fraser SA, Klassen DR, Feldman LS, et al. (2003) Evaluating laparoscopic skills: setting the pass/fail score for the MISTELS system. Surg Endosc 17:964–967PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  1. 1.Department of SurgerySteinberg-Bernstein Centre for Minimally Invasive Surgery & Innovation, McGill University Health CentreMontrealCanada

Personalised recommendations