Toward reliable operative assessment: the reliability and feasibility of videotaped assessment of laparoscopic technical skills.
BACKGROUND
Decision making on the competency of surgical trainees to perform laparoscopic procedures has been hampered by the lack of reliable methods to evaluate operative performance. The goal of this study was to develop a feasible and reliable method of evaluation.


METHODS
Twenty-nine senior surgical residents were videotaped performing a low anterior resection and a Nissen fundoplication in a pig. Ten blinded laparoscopists rated the videos independently on two scales. Rating time was minimized by allowing raters to fast-forward through the tapes at their discretion. Interrater reliability and the time required to rate a procedure were assessed.


RESULTS
Rating time per procedure was a median of 15 min (range, 6-40). The mean interrater reliability for the two scales was 0.74.


CONCLUSIONS
The use of videotapes of operations enabled multiple raters to assess a performance reliably and shortened assessment times by 80%. This assessment technique shows potential as a means of evaluating the performance of advanced laparoscopic procedures by surgical trainees.
Dath
D
D
Department of Surgery, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Regehr
G
G
Birch
D
D
Schlachta
C
C
Poulin
E
E
Mamazza
J
J
Reznick
R
R
MacRae
H M
HM
D002983:Clinical Competence; D005240:Feasibility Studies; D007396:Internship and Residency; D010535:Laparoscopy / Q000592:standards*; D015203:Reproducibility of Results; D014741:Video Recording