PT  - JOURNAL ARTICLE
AU  - Jacques Balayla
AU  - Simon Bergman
AU  - Gabriela Ghitulescu
AU  - Liane S. Feldman
AU  - Shannon A. Fraser
TI  - Knowing the operative game plan: a novel tool for the assessment of surgical procedural knowledge
AID  - 10.1503/cjs.015411
DP  - 2012 Aug 01
TA  - Canadian Journal of Surgery
PG  - S158--S162
VI  - 55
IP  - 4 Suppl 2
4099  - http://canjsurg.ca/content/55/4_Suppl_2/S158.short
4100  - http://canjsurg.ca/content/55/4_Suppl_2/S158.full
SO  - CAN J SURG2012 Aug 01; 55
AB  - Background: What is the source of inadequate performance in the operating room? Is it a lack of technical skills, poor judgment or a lack of rocedural knowledge? We created a surgical procedural knowledge (SPK) assessment tool and evaluated its use.Methods: We interviewed medical students, residents and training program staff on SPK assessment tools developed for 3 different common general surgery procedures: inguinal hernia repair with mesh in men, laparoscopic cholecystectomy and right hemicolectomy. The tools were developed as a step-wise assessment of specific surgical procedures based on techniques described in a current surgical text. We compared novice (medical student to postgraduate year [PGY]-2) and expert group (PGY-3 to program staff) scores using the Mann–Whitney U test. We calculated the total SPK score and defined a cut-off score using receiver operating characteristic analysis.Results: In all, 5 participants in 7 different training groups (n = 35) underwent an interview. Median scores for each procedure and overall SPK scores increased with experience. The median SPK for novices was 54.9 (95% confidence interval [CI] 21.6–58.8) compared with 98.05 (95% CP 94.1–100.0) for experts (p = 0.012). The SPK cut-off score of 93.1 discriminates between novice and expert surgeons.Conclusion: Surgical procedural knowledge can reliably be assessed using our SPK assessment tool. It can discriminate between novice and expert surgeons for common general surgical procedures. Future studies are planned to evaluate its use for more complex procedures.