title: The reliability of multiple objective measures of surgery and the role of human performance.
abstract: BACKGROUND
  There is a need for reliable and valid objective methods of technical skills in surgery. Six-bench surgical top stations have been combined to assess basic surgical trainees (BSTs) objectively. The current study examines its reliability and validity across repeat sittings.
  
  
  METHODS
  Eleven surgical trainees (6 senior BSTs and 5 higher surgical trainees [HSTs]) undertook 5 sittings of the 6-station assessment designed to be completed within 90 minutes. The 6 stations consisted of knot tying, suturing, closure of enterotomy, excision of sebaceous cyst, laparoscopic task, and instrument examination. Methods of analysis employed were motion analysis, observation with criteria, and inbuilt simulation metrics.
  
  
  RESULTS
  On analysis 3 knot tying and suturing stations exhibited significant differences in either time or movement; any difference was over by the second run. The intertest reliabilities were .66, .74, .55, .51, and .65 for the 5 runs. The intratest reliability across repeated sittings varied from .56 to .96. The inter-rater reliability for video assessment varied from .77 to .94.
  
  
  CONCLUSIONS
  The assessment is reliable and valid across repeated sittings. Its use in assessment of basic technical skills needs to be encouraged.
authors.affiliation: Faculty of Medicine, Imperial College of Science, Technology and Medicine, 10th Floor QEQM Wing, St. Mary's Hospital, London, W2 1NY United Kingdom. s.bann@ic.ac.uk
authors.forename: Simon
authors.initials: S
authors.lastname: Bann
authors.forename: Iain Mackay
authors.initials: IM
authors.lastname: Davis
authors.forename: Krishna
authors.initials: K
authors.lastname: Moorthy
authors.forename: Yaron
authors.initials: Y
authors.lastname: Munz
authors.forename: Juan
authors.initials: J
authors.lastname: Hernandez
authors.forename: Mansoor
authors.initials: M
authors.lastname: Khan
authors.forename: Vivek
authors.initials: V
authors.lastname: Datta
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D002983:Clinical Competence; D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D010535:Laparoscopy; D015203:Reproducibility of Results; D013525:Surgical Instruments; D013536:Suture Techniques; D006113:United Kingdom