title: Can both residents and chief physicians assess surgical skills?
abstract: BACKGROUND
  It is known that structured assessment of an operation can provide trainees with useful knowledge and potentially shorten their learning curve. However, methods for objective assessment have not been widely adopted into the clinical setting. This might be because of a lack of expertise using an assessment tool. The aim of this present study was to investigate if a validated laparoscopic procedure-specific assessment tool could be used by doctors with different levels of experience.
  
  
  METHODS
  The study was conducted as an observer-blinded, prospective cohort study. Three video recordings of a right-side laparoscopic salpingectomy were distributed to ten chief physicians, eight residents (fourth year trainees), and two expert assessors (all in gynecology) in order to be assessed using a validated procedure-specific assessment tool. The three salpingectomies were selected because they easily showed the different operational levels: novice, intermediate, and expert. The two expert assessors, i.e., our gold standard, were familiar with the OSA-LS assessment scale, but the chief physicians and the residents were not. All participants were blinded to the fact that surgeons with different experience had performed the salpingectomies.
  
  
  RESULTS
  No significant differences between the residents and chief physicians were observed in any of the three assessed operations: novice, p = 0.63; intermediate, p = 0.93; and expert, p = 0.93. The chief physicians and residents matched our gold standard in assessing the intermediate operation (p = 0.177), but not the novice operation (p = 0.005) or the expert operation (p = 0.001).
  
  
  CONCLUSIONS
  Residents and chief physicians generated similar performance scores when assessing operations using a laparoscopic procedure-specific assessment scale, and they could distinguish performance levels between the surgeons. They matched the assessment score of our expert on the intermediate operation. We conclude that a procedure-specific assessment scale can be used by both residents and chief physicians when giving formative feedback.
authors.affiliation: Department of Gynaecology and Obstetrics, The Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University Hospital of Copenhagen, Section 4074, Door 7248, Blegdamsvej 9, 2100 Copenhagen, Denmark. jeanett.oestergaard@rh.regionh.dk
authors.forename: Jeanett
authors.initials: J
authors.lastname: Oestergaard
authors.forename: Christian Rifbjerg
authors.initials: CR
authors.lastname: Larsen
authors.forename: Mathilde
authors.initials: M
authors.lastname: Maagaard
authors.forename: Teodor
authors.initials: T
authors.lastname: Grantcharov
authors.forename: Bent
authors.initials: B
authors.lastname: Ottesen
authors.forename: Jette Led
authors.initials: JL
authors.lastname: Sorensen
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D006176:Gynecology; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000592:standards*; D011446:Prospective Studies; D058994:Salpingectomy / Q000592:standards*; D011795:Surveys and Questionnaires; D014741:Video Recording