title: Essential hand surgery procedures for mastery by graduating plastic surgery residents: a survey of program directors.
abstract: BACKGROUND
  This study was designed to establish the essential hand surgery procedures that should be mastered by graduating plastic surgery residents. This framework can then be used as a guideline for developing Objective Structured Assessment of Technical Skill to teach technical skills in hand surgery.
  
  
  METHODS
  Ten expert hand surgeons were surveyed regarding the essential hand surgery procedures that should be mastered by graduating plastic surgery residents. The top 10 procedures from this survey were then used to survey all 89 Accreditation Council for Graduate Medical Education-approved plastic surgery program directors.
  
  
  RESULTS
  There was a 69 percent response rate to the program director survey (n = 61). The top nine hand surgery procedures included open carpal tunnel release, open A1 pulley release, digital nerve repair with microscope, closed reduction and percutaneous pinning of metacarpal fracture, excision of dorsal or volar ganglion, zone II flexor tendon repair with multistrand technique, incision and drainage of the flexor tendon sheath for flexor tenosynovitis, flexor tendon sheath steroid injection, and open cubital tunnel release.
  
  
  CONCLUSIONS
  Surgical educators need to develop objective methods to teach and document technical skill. The Objective Structured Assessment of Technical Skill is a valid method for accomplishing this task. There has been no consensus regarding which hand surgery procedures should be mastered by graduating plastic surgery residents. The authors have identified nine procedures that are overwhelmingly supported by plastic surgery program directors. These nine procedures can be used as a guideline for developing Objective Structured Assessment of Technical Skill to teach and document technical skills in hand surgery.
authors.affiliation: Stanford, Calif.; and Seattle, Wash. From the Division of Plastic Surgery, Department of Surgery, and the Robert A. Chase Center for Hand and Upper Limb, Stanford University Hospital; and the Department of Orthopedic Surgery and the Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center.
authors.forename: Shelley S
authors.initials: SS
authors.lastname: Noland
authors.forename: Lauren H
authors.initials: LH
authors.lastname: Fischer
authors.forename: Gordon K
authors.initials: GK
authors.lastname: Lee
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Friedrich
authors.forename: Vincent R
authors.initials: VR
authors.lastname: Hentz
mesh_terms: D000068:Accreditation; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D002983:Clinical Competence; D003625:Data Collection; D004503:Education, Medical, Graduate / Q000592:standards*; D005180:Faculty, Medical; D005257:Fellowships and Scholarships / Q000592:standards*; D006225:Hand / Q000601:surgery; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D019651:Plastic Surgery Procedures / Q000193:education*; D013518:Surgery, Plastic / Q000193:education*