The examination assessment of technical competence in vascular surgery.
BACKGROUND
The European Board of Surgery Qualification in Vascular Surgery is a pan-European examination for vascular surgeons who have attained a national certificate of completion of specialist training. A 2-year study was conducted before the introduction of a technical skills assessment in the examination.


METHODS
The study included 30 surgeons: 22 candidates and eight examiners. They were tested on dissection (on a synthetic saphenofemoral junction model), anastomosis (on to anterior tibial artery of a synthetic leg model) and dexterity (a knot-tying simulator with electromagnetic motion analysis). Validated rating scales were used by two independent examiners. Composite knot-tying scores were calculated for the computerized station. The stations were weighted 35, 45 and 20 percent, respectively.


RESULTS
Examiners performed better than candidates in the dissection (P<0.001), anastomosis (P=0.002) and dexterity (P=0.005) stations. Participants performed consistently in the examination (dissection versus anastomosis: r=0.79, P<0.001; dexterity versus total operative score: r=-0.73, P<0.001). Interobserver reliability was high (alpha=0.91). No correlation was seen between a candidate's technical skill and oral examination performance or logbook-accredited scores.


CONCLUSIONS
Current surgical examinations do not address technical competence. This model appears to be a valid assessment of technical skills in an examination setting. The standards are set at a level appropriate for a specialist vascular surgeon.
Pandey
V A
VA
Regional Vascular Unit, Mary Stanford Wing, St. Mary's Hospital, London W2 1NY, UK, and Department of Athens University School of Medicine, Greece.
Wolfe
J H N
JH
Liapis
C D
CD
Bergqvist
D
D
D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000379:methods / Q000592:standards; D004521:Educational Measurement / Q000592:standards; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards*; D015588:Observer Variation; D010865:Pilot Projects; D015203:Reproducibility of Results; D014656:Vascular Surgical Procedures / Q000193:education / Q000592:standards*