Objective structured assessment of technical skills for repair of fourth-degree perineal lacerations.
OBJECTIVE
The objective of this study was to assess the reliability and validity of an objective structured assessment of technical skills (OSATS) for repair of fourth-degree obstetric lacerations on a surgical model.


METHODS
Three blinded judges reviewed recordings of 20 junior and 20 senior obstetrics-gynecology residents performing simulated perineal repairs using a beef tongue model. Judges completed task-specific OSATS and global rating scales for each repair. Six recordings were rereviewed after 2 weeks. Inter- and intrarater reliability and construct validity were assessed.


RESULTS
Interrater reliability was 0.80 for task-specific OSATS and 0.59 for the global rating scale. Intrarater reliability was poor. Construct validity was demonstrated, with senior residents scoring higher than junior residents on task-specific OSATS (13.0 vs 10.5; P = .007) and the global rating scale (24.0 vs 19.3; P = .001).


CONCLUSIONS
We found good interrater reliability and construct validity using a task-specific OSATS for fourth-degree perineal laceration repair. This instrument shows promise as a tool for competency-based evaluations.
Siddiqui
Nazema Y
NY
Division of Urogynecology and Reconstructive Pelvic Surgery, Duke University Medical Center, Durham, NC, USA.
Stepp
Kevin J
KJ
Lasch
Susan J
SJ
Mangel
Jeffrey M
JM
Wu
Jennifer M
JM
D000818:Animals; D002417:Cattle; D002983:Clinical Competence; D016001:Confidence Intervals; D004503:Education, Medical, Graduate / Q000379:methods; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007396:Internship and Residency / Q000379:methods*; D022125:Lacerations / Q000473:pathology / Q000601:surgery*; D017145:Models, Educational; D015588:Observer Variation; D013513:Obstetric Surgical Procedures / Q000193:education*; D010502:Perineum / Q000293:injuries / Q000601:surgery*; D011336:Probability; D015203:Reproducibility of Results; D013536:Suture Techniques / Q000193:education; D014059:Tongue