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Can both residents and chief physicians assess surgical skills?

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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.

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Acknowledgments

Thanks to Susanne Rosthoej, Department of Bio Statistics, Faculty of Health Sciences, University of Copenhagen, for statistical support.

Disclosure

Dr. J. Oestergaard, Dr. C. R. Larsen, Dr. M. Maagaard, Dr. T. Grantcharov, Dr. B. Ottesen, and Dr. J. L. Sorensen have no conflicts of interest or no financial ties to disclose.

Funding

Rigshospitalet, University Hospital of Copenhagen in the Capital Region of Denmark, funded this study.

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Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, The Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University Hospital of Copenhagen, Section 4074, Door 7248, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Jeanett Oestergaard, Christian Rifbjerg Larsen, Mathilde Maagaard, Bent Ottesen & Jette Led Sorensen

  2. Department of Surgery, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada

    Teodor Grantcharov

Authors
  1. Jeanett Oestergaard
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  2. Christian Rifbjerg Larsen
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  3. Mathilde Maagaard
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  4. Teodor Grantcharov
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  5. Bent Ottesen
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  6. Jette Led Sorensen
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Corresponding author

Correspondence to Jeanett Oestergaard.

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Oestergaard, J., Larsen, C.R., Maagaard, M. et al. Can both residents and chief physicians assess surgical skills?. Surg Endosc 26, 2054–2060 (2012). https://doi.org/10.1007/s00464-012-2155-1

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  • DOI: https://doi.org/10.1007/s00464-012-2155-1

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