title: Comprehensive assessment of thyroidectomy skills development: a pilot project.
abstract: OBJECTIVE
  To test the validity, reliability, and feasibility of an evaluation tool designed to measure the development of trainees' surgical skills in the operating room for thyroid surgery.
  
  
  METHODS
  Prospective validation study.
  
  
  METHODS
  A modified Delphi technique was employed to develop a new Objective Structured Assessment of Technical Skills-based instrument for thyroid surgery. During a 1-year period, 16 otolaryngology-head and neck surgery residents (ranging from postgraduate year 2 to 6) and one endocrine surgery fellow were evaluated by one faculty member obtaining a total of 94 evaluations. Performance was rated using a task-based checklist (TBC) and a global rating scale (GRS). The TBC measured trainees' thyroidectomy technical skills, and the GRS assessed their overall surgical performance.
  
  
  RESULTS
  Based on four clinical levels (junior, intermediate, senior, and surgical fellow) our tool demonstrated construct validity for both components of the assessment instrument, specifically for the TBC showing a mean difference of 0.9 (95% confidence interval: 0.5-1.3, P<.001) between the contiguous clinical levels senior versus intermediate. Cronbach α, a measure of internal consistency, was 0.96 for both components of the instrument. The correlation between the TBC and GRS was also high within trainee (r=0.62, n=94, P<.001) and across trainees (r=0.96, n=17, P<.001).
  
  
  CONCLUSIONS
  Our tool proved to be a valid, reliable, and feasible instrument for assessing competency in thyroid surgery. It is effective in providing timely formative feedback during and upon the conclusion of the surgical procedure by identifying procedural tasks for which additional training is necessary. In addition, it enables longitudinal tracking of residents' surgical performance, thus ensuring their appropriate development.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Diaz Voss Varela
authors.forename: Mohammad U
authors.initials: MU
authors.lastname: Malik
authors.forename: Carol B
authors.initials: CB
authors.lastname: Thompson
authors.forename: Charles W
authors.initials: CW
authors.lastname: Cummings
authors.forename: Nasir I
authors.initials: NI
authors.lastname: Bhatti
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Tufano
mesh_terms: D057189:Checklist; D002983:Clinical Competence; D006801:Humans; D010865:Pilot Projects; D011446:Prospective Studies; D013965:Thyroidectomy / Q000592:standards*