title: Systematic review of predictors of surgical performance.
abstract: BACKGROUND
  Selection criteria for surgical training are not scientifically proven. There is a need to define which attributes predict future surgical performance. The aim of this study was to examine the predictive value of specific attributes that impact on surgical performance.
  
  
  METHODS
  All studies assessing the predictive power of specified attributes with regard to outcome measures of surgical performance in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Educational Resources Information Centre databases, and bibliographies of selected articles from 1950 to November 2010 were considered for inclusion by two independent reviewers. Information on study identifiers, participant characteristics, predictors assessed, evaluation methods for predictors, outcome measures, results and statistical analysis was collected. Quality assessment was carried out using the Hayden criteria.
  
  
  RESULTS
  Visual-spatial perception correlated with both subjective and objective assessments of surgical performance, including rate of skill acquisition. Visual-spatial perception did not correlate with operative ability in experts, although it did with operative ability at the end of a training programme. Psychomotor aptitude, assessed collectively, correlated with rate of skill acquisition. Academic achievement predicted completion of a training programme and passing end-of-training examinations, but did not predict clinical performance during the training programme.
  
  
  CONCLUSIONS
  Intermediate- and high-level visual-spatial perception, as well as psychomotor aptitude, can be used as criteria for assessing candidates for surgical training. Academic achievement is an effective predictor of successful completion of training programmes and should continue to form part of the assessment of surgical candidates.
authors.affiliation: Academic Surgical Unit, Imperial College London, UK. zeshaan@doctors.org.uk
authors.forename: Z N
authors.initials: ZN
authors.lastname: Maan
authors.forename: I N
authors.initials: IN
authors.lastname: Maan
authors.forename: A W
authors.initials: AW
authors.lastname: Darzi
authors.forename: R
authors.initials: R
authors.lastname: Aggarwal
mesh_terms: D001076:Aptitude / Q000502:physiology; D001077:Aptitude Tests; D002983:Clinical Competence / Q000592:standards*; D004526:Efficiency / Q000502:physiology; D013502:General Surgery / Q000592:standards*; D006801:Humans; D059032:Learning Curve; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D012189:Retrospective Studies; D013028:Space Perception / Q000502:physiology; D013997:Time Factors; D018910:Video Games; D014796:Visual Perception / Q000502:physiology