Assessment of operative competence during carotid endarterectomy.
BACKGROUND
Objective Structured Assessment of Technical Skills (OSATS) has been used to assess operative competence. The aim was to evaluate its role in carotid endarterectomy (CEA).


METHODS
Over 2 years, 17 trainees and 11 consultants were assessed by a single observer using a task-specific checklist and global ratings. Operating time and previous experience were also recorded.


RESULTS
Trainees had previously performed fewer CEAs than consultants (median (interquartile range, i.q.r.) 15 (7-24) versus 94 (61-133) respectively; P < 0.001) and they took longer to perform operations (median (i.q.r.) 128 (119-143) versus 90 (82.5-98.5) min; P < 0.001). Trainees achieved lower task-specific (median (i.q.r.) 23 (17-26) versus 25 (24.5-27.5); P = 0.031) and global (33 (30-35) versus 40 (36.5-43); P = 0.001) scores than consultants. There was a strong positive correlation between task-specific scores and experience for trainees (r = 0.83, P < 0.001), but not for consultants. Global ratings correlated with experience for trainees (r = 0.69, P = 0.002) and more so for consultants (r = 0.82, P = 0.002). There was a positive correlation between task-specific and global scores for trainees (r = 0.67, P = 0.003), but not for consultants.


CONCLUSIONS
Task-specific checklists were more discriminatory between trainees and may be useful for formative assessment (training). Global ratings were more discriminatory for consultants and may be useful for summative assessment (examination or revalidation).
Beard
J D
JD
Sheffield Vascular Institute, Northern General Hospital, Sheffield S5 7AU, UK. Jonathan.D.Beard@sth.nhs.uk
Choksy
S
S
Khan
S
S
D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement; D016894:Endarterectomy, Carotid / Q000193:education / Q000592:standards*; D006801:Humans; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards*