Value of an objective assessment tool in the operating room
| Autor: | Ron Wolterbeek, Wendela Kolkman, Frank Willem Jansen, Baptist Trimbos, Ellen Hiemstra |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Operating Rooms Educational measurement medicine.medical_specialty media_common.quotation_subject Certification Credentialing Likert scale medicine Humans Quality (business) Medical physics Netherlands media_common business.industry Research Internship and Residency Checklist Surgery Gynecology Learning curve Scale (social sciences) Linear Models Female Clinical Competence Educational Measurement business Knowledge of Results Psychological |
| Zdroj: | Canadian Journal of Surgery, 54(2), 116-122 |
| Popis: | Nowadays, it is becoming more and more difficult to achieve surgical proficiency. Residents experience less training owing to reduced working hours and a decreased surgical caseload.1 Additionally, with the development of new surgical techniques, skills acquisition is more challenging.2 Currently, basic surgical procedures are sufficiently mastered after finishing residency training, but advanced procedures are not.3 Ultimately, skills deficiencies will impede postresidency performance.4 Moreover, residency programs still rely heavily on informal and subjective evaluations based on recollections of supervisors.5,6 Therefore, on one hand, surgical skills training needs to become more efficient, and on the other hand, appropriate assessment is required to optimally benefit from the spare learning moments in the operating room (OR). An objective assessment tool can fulfill an important role during operative training.7,8 Such a tool can help the learning process through constructive feedback on performance. Second, an assessment tool can be applied to establish competency levels and to mark progression. Finally, it can provide benchmark criteria to be used as a training goal or for credentialing purposes.9,10 To fulfill this need for an objective assessment tool, the Objective Structured Assessment of Technical Skills (OSATS) was developed by Martin and colleagues11 in Toronto in 1997. An OSATS consists of a procedure-specific checklist, a pass/fail judgment and a global rating scale. The latter turned out to be superior in terms of reliability and validity.11–13 On this global rating scale, domains are scored on a Likert scale ranging from 1 to 5, with an explicit description at points 1, 3 and 5. So far, studies about the quality of OSATS have mainly been conducted in simulators or live animal models.14 Although applying OSATS in simulator settings has the benefit of repeated practice without the risk of harming patients, simulators will never perfectly mimic operative conditions. Therefore, OSATS have been implemented for the assessment of real surgical procedures on a large scale in residency programs in the Netherlands. Moreover, plans are being developed to use this form of assessment tool for certification purposes after residency training. However, only a few studies have investigated the value of the intraoperative use of OSATS.7,15 Aggarwal and colleagues7 found that the OSATS score discriminates between a novice and an expert surgeon performing a laparoscopic cholecystectomy demonstrated by video-based assessment. Bodle and colleagues15 concluded from feedback questionnaires that trainers and trainees in the United Kingdom perceived the OSATS to be valid and valuable. In the absence of data on the implementation of OSATS in daily practice, the current study was conducted to assess the value of the tool in clinical practice by analyzing residents’ learning curves for a variety of surgical procedures in gynecology. |
| Databáze: | OpenAIRE |
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