title: Assessing operative performance in advanced laparoscopic colorectal surgery.
abstract: BACKGROUND
  Competent technical skills performance in complex operations is vital for satisfactory patient outcome. Assessing these skills is therefore of paramount importance. In this study we aim to develop and validate a new tool that can assess both generic and specific technical skills in advanced complex laparoscopic colorectal surgery in the operating room.
  
  
  METHODS
  Hierarchical task analysis was constructed for generic and specific technical skills on three key advanced laparoscopic colorectal operations (right hemicolectomy, sigmoid colectomy, and anterior resection) after expert discussions. Likert scales were then constructed individually for generic and specific technical skills for each operation using hierarchical task analysis for each operation to identify key elements and steps for each operation. Each operation was assessed independently and blindly by two experienced surgeons.
  
  
  RESULTS
  Eighty-four live real operations performed by six consultants and eight trainees were assessed. Interclass correlation coefficient between the two observers was 0.94 (P < or = 0.05) for generic technical skills and 0.88 (P < or = 0.05) for the operation-specific technical skills. Construct validity for both generic and specific technical skills for consultants and trainees was significant using ANOVA (P < or = 0.05). All consultants therefore consistently performed better in both generic and specific technical skills compared to their trainees.
  
  
  CONCLUSIONS
  This new assessment tool of generic and specific technical skills in advanced laparoscopic colorectal surgery is reliable and has face, content, concurrent, and construct validities. The tool has the possibility of being used as a surgical training and appraisal tool.
authors.affiliation: Colorectal Surgical Unit, Whittington Hospital, London, N19 5NF, UK. s.sarker@imperial.ac.uk
authors.forename: Sudip K
authors.initials: SK
authors.lastname: Sarker
authors.forename: Isis
authors.initials: I
authors.lastname: Kumar
authors.forename: Conor
authors.initials: C
authors.lastname: Delaney
mesh_terms: D057189:Checklist; D002983:Clinical Competence; D003082:Colectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011446:Prospective Studies; D013647:Task Performance and Analysis