title: Assessing fundamental 2-dimensional understanding of basic soft tissue techniques.
abstract: OBJECTIVE
  To develop a written practical examination and scoring system for assessing trainee skills in basic soft-tissue techniques.
  
  
  METHODS
  A brief written practical examination was developed to assess the ability of trainees to sketch preoperative plans and postoperative results for common soft-tissue techniques: simple-excision, M-plasty, geometric broken line closure, Z-plasty, V-to-Y flap, and rhombic flap. A scoring system was developed to assign 0 to 5 points to each of 10 items on the examination for a total score of 0-50. The 15-minute examination was administered as a pretest, posttest, and 3-month posttest assessment as part of a soft-tissue course at our institution.
  
  
  METHODS
  University of Minnesota, Otolaryngology Department.
  
  
  RESULTS
  Three raters reviewed all examination answer sheets independently. The pretest scores of examinees correlated strongly with their level of training; the average pretest for junior residents (PGY 1-2) compared with senior residents (PGY 4-5) was 17.3 (of 50) versus 26.0 (p < 0.01). The scoring system showed a high intrarater reliability and high interrater reliability with correlation coefficients of r = 0.99 and r = 0.95, respectively and agreement coefficients of κ = 0.82 and κ = 0.77, respectively.
  
  
  CONCLUSIONS
  This written practical examination and scoring system may be used to assess the skills of trainees accurately in basic soft tissue techniques and to expose areas of deficiency that can be addressed in future training sessions.
authors.affiliation: Department of Otolaryngology, Division of Facial Plastic and Reconstructive Surgery, University of Minnesota, Minneapolis, Minnesota 55455, USA. jabb00005@umn.edu
authors.forename: Noel
authors.initials: N
authors.lastname: Jabbour
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Dobratz
authors.forename: Harley S
authors.initials: HS
authors.lastname: Dresner
authors.forename: Peter A
authors.initials: PA
authors.lastname: Hilger
mesh_terms: D002983:Clinical Competence; D062109:Dermatologic Surgical Procedures; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D010036:Otolaryngology / Q000193:education*; D013518:Surgery, Plastic / Q000193:education*; D013524:Surgical Flaps