Visuospatial and technical ability in the selection and assessment of higher surgical trainees in the London deanery.
BACKGROUND
Despite awareness of the limitations of current selection and competency assessments, there is little consensus and alternatives have not been readily accepted. Essential surgical skills include visuospatial and technical ability. The aim of this study was to survey current methods of higher surgical trainee selection and assessment. We suggest ways to improve the process.


METHODS
Nine surgical training programmes in the London deanery were surveyed through questionnaires to programme directors, existing trainees and examination of deanery publications.


RESULTS
Testing of visuospatial and technical ability was piloted at selection only in a single general surgical department. Practical skills were assessed in 3/9 (33%) specialties (ENT, plastic and general surgery). Once selected, no specialty tested visuospatial and technical ability. Practical skills were tested in only 1/9 (11%) specialties (plastic surgery). The remaining 8/9 (89%) were 'assessed' by interview.


CONCLUSIONS
Lack of visuospatial and technical ability assessment was identified at selection and during higher surgical training. Airlines have long recognised early identification of these qualities as critical for efficient training. There is a need for more objective methods in this area prior to selection as time to assess surgical trainees during long apprenticeships is no longer available. We advocate a suitably validated competency-based model during and at completion of training.
Tansley
P
P
Department of Plastic and Reconstructive Surgery, Royal Free Hospital, London, UK. patrick.tansley@btinternet.com
Kakar
S
S
Withey
S
S
Butler
P
P
D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D003657:Decision Making; D004503:Education, Medical, Graduate; D013502:General Surgery / Q000193:education*; D006801:Humans; D008131:London; D011597:Psychomotor Performance / Q000502:physiology; D012570:School Admission Criteria; D012577:Schools, Medical; D013028:Space Perception / Q000502:physiology*