RT Journal Article
SR Electronic
T1 Knowing the operative game plan: a novel tool for the assessment of surgical procedural knowledge
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP S158
OP S162
DO 10.1503/cjs.015411
VO 55
IS 4 Suppl 2
A1 Jacques Balayla
A1 Simon Bergman
A1 Gabriela Ghitulescu
A1 Liane S. Feldman
A1 Shannon A. Fraser
YR 2012
UL http://canjsurg.ca/content/55/4_Suppl_2/S158.abstract
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.