Video assessment of basic surgical trainees' operative skills.
BACKGROUND
We previously described a feasible, reliable, valid, and acceptable clinical assessment form for basic surgical trainees (BSTs). We now recently assessed tissue-handling skills using real-time assessment (RTA) and video assessment (VA) and addressed feasibility, reliability, validity, and trainer-trainee agreement using the same assessment form.


METHODS
Nine BSTs were videotaped as they performed open inguinal hernia repairs at 6 and 12 months of surgical training. Edited videotapes were independently rated by 7 consultants and 5 trainees using the technical part of the Edinburgh BST Assessment Form (EBSTAF-Tech), the Toronto Global Rating Scale of Surgical Performance (Toronto scale), and a visual analogue scale.


RESULTS
RTA and VA both proved to be reliable tools (RTA alpha > or = .85; VA alpha > or = .76; interclass correlation coefficient [ICC] > or = .69, rho > or = .694 [P < or = .004]), but RTA was not construct valid. VA scores distinguished consultant from trainee operators (Mann-Whitney P < .02), with trainers able to discriminate between trainee levels (Wilcoxon P = .01 to .023). Concurrent validity was demonstrated by the VA (trainers tau-b = .71 to .79 [P < .001] and trainees tau-b = .79 to .82 [P < .001]) with good trainer-trainee agreement (EBSTAF-Tech tau-b = .35 [P = .03), Toronto tau-b = .46 [P = .006), and visual analogue scale tau-b = .46 [P = .006]).


CONCLUSIONS
VA of BST tissue-handling skills is feasible, reliable, valid, and highly sensitive. It may also improve trainee self-assessment skills by promoting reflective practice.
Driscoll
Peter J
PJ
Department of Clinical and Surgical Sciences (Surgery), New Royal Infirmary, Edinburgh, UK.
Paisley
Anna M
AM
Paterson-Brown
Simon
S
D002983:Clinical Competence; D004521:Educational Measurement / Q000379:methods*; D005240:Feasibility Studies; D013502:General Surgery / Q000193:education*; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D015203:Reproducibility of Results; D014743:Videotape Recording