title: Program for laparoscopic urological skills assessment: setting certification standards for residents.
abstract: OBJECTIVE
  There is growing pressure from the government and the public to define proficiency standards for surgical skills. Aim of this study was to estimate the reliability of the Program for Laparoscopic Urological Skills (PLUS) assessment and to set a certification standard for second-year urological residents.
  
  
  METHODS
  Fifty participants were assessed on performance time and performance quality to investigate the reliability of the PLUS assessment. Generalisability coefficient of 0.8, on a scale of 0 to 1.0, was considered to indicate good reliability for assessment purposes. Pass/fail standards were based on laparoscopic experience: Novices, intermediates, and experts (>100 procedures). The pass/fail standards were investigated for the PLUS performances of 33 second-year urological residents.
  
  
  RESULTS
  Fifteen novices, twenty-three intermediates and twelve experts were included. An inter-trial reliability of >0.80 was reached with two trials for each task. Inter-rater reliability of the quality measurements was 0.79 for two judges. Pass/fail scores were determined for the novice/intermediate boundary and the intermediate/expert boundary. Pass rates for second-year residents were 63.64% and 9.09%, respectively.
  
  
  CONCLUSIONS
  The PLUS assessment is reliable for setting a certification standard for second-year urological residents that serves as a starting point for residents to proceed to the next level of laparoscopic competency.
authors.affiliation: Catharina Hospital Eindhoven, Eindhoven, the Netherlands.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Tjiam
authors.forename: Barbara M A
authors.initials: BM
authors.lastname: Schout
authors.forename: Ad J M
authors.initials: AJ
authors.lastname: Hendrikx
authors.forename: Arno M M
authors.initials: AM
authors.lastname: Muijtjens
authors.forename: Albert J J A
authors.initials: AJ
authors.lastname: Scherpbier
authors.forename: J Alfred
authors.initials: JA
authors.lastname: Witjes
authors.forename: Cees P M
authors.initials: CP
authors.lastname: Van Der Vleuten
mesh_terms: D000293:Adolescent; D000328:Adult; D002568:Certification; D002983:Clinical Competence; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D010535:Laparoscopy / Q000193:education / Q000592:standards*; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D013997:Time Factors; D013520:Urologic Surgical Procedures / Q000193:education / Q000379:methods*; D055815:Young Adult