Assessing surgical skill using bench station models.
BACKGROUND
The acquisition of surgical skill is one of the essentials of good surgical practice. The training of plastic surgeons is presently unstructured, with few objective measures of surgical skill. The trainee's time to acquire skills may be inadequate because of the shortened time for training with the Calman system. There is also increasing pressure from the government to introduce testing of surgical competency for all surgeons. The authors introduce a series of tasks that allow assessment of technical skill among plastic surgical trainees.


METHODS
A range of surgeons with differing surgical skill were tested. They performed three tasks designed to assess their ability to suture skin, take a medium-thickness skin graft, and repair a tendon. The candidates were videotaped during the procedures and scored by four independent observers using the Objective Structured Assessment of Technical Skill scoring system. Each candidate was then given an overall competence score.


RESULTS
Sixty-five candidates were tested with an experience range from consultant to junior senior health officer. Results showed significant differences down the grades, with consultants performing the tasks with greater competency than their juniors (p = 0.004).


CONCLUSIONS
The authors have demonstrated a valid and reliable method of objectively measuring the surgical skill of plastic surgical trainees. The authors have shown that consultants perform better than the juniors and that the tasks are easily reproduced. This has implications for future assessment in that these tests may be used as formal assessment programs for testing and teaching trainees throughout their careers.
Khan
Mansoor S
MS
Aylesbury and London, United Kingdom From the Department of Academic Surgery, St. Mary's Hospital, and the Department of Plastic Surgery, Royal Free Hospital.
Bann
Simon D
SD
Darzi
Ara W
AW
Butler
Peter E M
PEM
D002983:Clinical Competence; D019651:Plastic Surgery Procedures / Q000193:education* / Q000592:standards*; D013518:Surgery, Plastic / Q000193:education*
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