title: Defining milestones toward competency in mastoidectomy using a skills assessment paradigm.
abstract: OBJECTIVE
  To establish milestones toward achievement of surgical competency by using an objective assessment tool designed to measure the development of mastoidectomy skills in the operating room (OR).
  
  
  METHODS
  Prospective longitudinal validation study.
  
  
  METHODS
  Fifty-six evaluations were conducted in the OR on nine otolaryngology residents from PGY (postgraduate year) 2 to PGY 5 over a period of 3 years. Technical performance was measured over time using a task-based checklist developed for assessment of mastoidectomy skills.
  
  
  RESULTS
  Three sets of technical milestones represented achievement of competency for progressively more complicated procedural steps: the first set was achieved after a mean of 6 +/- 4.3 cases, the second set after 9 +/- 6.7 cases (range of mean = 8-10 cases), and the third set after 13 +/- 6.4 cases (range of mean = 12-14 cases).
  
  
  CONCLUSIONS
  The acquisition of mastoidectomy skills can be integrated into surgical teaching in the OR, and this approach yields information that can aid individual skill development and program improvement. The identification of milestones in particular can help establish training benchmarks toward achievement of competency and in identifying trainees in need of remediation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland 21287, USA.
authors.forename: Howard W
authors.initials: HW
authors.lastname: Francis
authors.forename: Hamid
authors.initials: H
authors.lastname: Masood
authors.forename: Kulsoom
authors.initials: K
authors.lastname: Laeeq
authors.forename: Nasir I
authors.initials: NI
authors.lastname: Bhatti
mesh_terms: D019985:Benchmarking; D002983:Clinical Competence / Q000592:standards*; D003625:Data Collection; D006801:Humans; D007396:Internship and Residency; D008137:Longitudinal Studies; D008416:Mastoid / Q000601:surgery*; D010036:Otolaryngology / Q000193:education* / Q000592:standards; D016544:Patient Simulation; D011446:Prospective Studies; D014481:United States