title: Technical skills examination for general surgical trainees.
abstract: BACKGROUND
  The technical skills of surgical trainees are difficult to assess and compare objectively. This study involved a structured, multistation, technical skills examination that enables the stratification of surgical trainees.
  
  
  METHODS
  Twenty-two surgeons (five basic surgical trainees, eight junior specialist trainees, four senior specialist trainees and five consultants) participated in the study. All undertook a five-station technical skills examination consisting of three synthetic simulations (bowel anastomosis, vascular anastomosis, saphenofemoral dissection) and two virtual reality-based (flexible sigmoidoscopy and laparoscopy) assessment stations. Video-based analyses and in-built computer scoring were used to measure each surgeon's performance. The mean rank was determined for each variable, and the sum of the mean ranks produced a total score.
  
  
  RESULTS
  There was a significant improvement in overall performance with increasing seniority (P<0.001). Significant differences were observed between basic surgical trainees and junior specialist trainees (P=0.019), and between junior and senior specialist trainees (P=0.048), but not between senior trainees and consultants.
  
  
  CONCLUSIONS
  This examination successfully differentiated surgical skill, both between surgeons with different grades of experience and within the target study group of specialist trainees. The examination is feasible in terms of the timeframe needed to complete tasks, cost, and efficiency in performing video-based assessments.
authors.affiliation: Department of Surgical Oncology and Technology, 10th floor, Queen Elizabeth the Queen Mother Building, St Mary's Hospital, London W2 1NY, UK. v.datta@imperial.ac.uk
authors.forename: V
authors.initials: V
authors.lastname: Datta
authors.forename: S
authors.initials: S
authors.lastname: Bann
authors.forename: R
authors.initials: R
authors.lastname: Aggarwal
authors.forename: M
authors.initials: M
authors.lastname: Mandalia
authors.forename: J
authors.initials: J
authors.lastname: Hance
authors.forename: A
authors.initials: A
authors.lastname: Darzi
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000379:methods / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D004521:Educational Measurement / Q000592:standards; D013502:General Surgery / Q000193:education* / Q000592:standards; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards*; D013514:Surgical Procedures, Operative / Q000193:education / Q000592:standards