title: Undertaking procedure-based assessment is feasible in clinical practice.
abstract: BACKGROUND
  With the development of a new curriculum, workplace based assessments such as procedure-based assessment (PBA) are becoming increasingly common within surgical training. However, there have been concerns about the impact of these assessments on clinical practice. This study assessed the time taken to complete PBA forms to determine whether it is feasible in clinical practice.
  
  
  METHODS
  PBAs for three colorectal procedures (anterior resection, right hemicolectomy and anal fistula) were undertaken by various trainers and trainees. A pilot study was performed to identify potential reasons for incomplete forms and procedural modifications subsequently applied in the main study. Times taken to complete the consenting and operative components of the forms were recorded.
  
  
  RESULTS
  Incomplete forms in the pilot were mainly attributable to time constraints. In the main study, all assessments were completed within 30 min. Assessment times increased with complexity of the procedure. Median times for completing the consenting and operative components in anterior resection were 13 min (range, 8-15 min) and 15 min (range, 10-18 min), respectively.
  
  
  CONCLUSIONS
  PBAs are feasible in clinical practice and are valued by trainees as a means of enabling focused feedback and targeted training. Commitment from trainers and trainees will be required but, with adequate planning, the assessment tool is effective with minimal impact on clinical practice.
authors.affiliation: Department of Colorectal Surgery, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: K
authors.initials: K
authors.lastname: James
authors.forename: K
authors.initials: K
authors.lastname: Cross
authors.forename: M E
authors.initials: ME
authors.lastname: Lucarotti
authors.forename: A L
authors.initials: AL
authors.lastname: Fowler
authors.forename: T A
authors.initials: TA
authors.lastname: Cook