Resident self-assessment of operative performance.
BACKGROUND
In medicine, the development of expertise requires the recognition of one's capabilities and limitations. This study aimed to verify the accuracy of self-assessment for the performance of a surgical task, and to determine whether self-assessment may be improved through self-observation or exposure to relevant standards of performance.


METHODS
Twenty-six senior surgical residents were videotaped performing a laparoscopic Nissen fundoplication in a pig. Experts rated the videos using two scoring systems. Subjects evaluated their performances after performance of the Nissen, after self-observation of their videotaped performance, and after review of four videotaped "benchmark" performances.


RESULTS
Expert interrater reliability was 0.66 (intraclass correlation coefficient). The correlation between experts' and residents' self-evaluations was initially moderate (r = 0.50, P <0.01), increasing significantly after the residents reviewed their own videotaped performance to r = 0.63 (Deltar = 0.13, P <0.01), yet did not change after review of the benchmarks.


CONCLUSIONS
Self-observation of videotaped performance improved the residents' ability to self-evaluate.
Ward
Mylène
M
Centre for Research in Education, University Health Network, and Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
MacRae
Helen
H
Schlachta
Christopher
C
Mamazza
Joseph
J
Poulin
Eric
E
Reznick
Richard
R
Regehr
Glenn
G
D000818:Animals; D019985:Benchmarking / Q000379:methods*; D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000592:standards; D018662:Fundoplication / Q000592:standards*; D005764:Gastroesophageal Reflux / Q000601:surgery; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D015397:Program Evaluation; D015203:Reproducibility of Results; D012655:Self-Evaluation Programs / Q000379:methods*; D013552:Swine; D014743:Videotape Recording