title: Technical skills assessment toolbox: a review using the unitary framework of validity.
abstract: OBJECTIVE
  The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools, using contemporary framework of validity.
  
  
  BACKGROUND
  Competency-based training has become the predominant model in surgical education and assessment of performance is an essential component. Assessment methods must produce valid results to accurately determine the level of competency.
  
  
  METHODS
  A search was performed, using PubMed and Google Scholar, to identify tools that have been developed for assessment of the targeted technical skills.
  
  
  RESULTS
  A total of 23 assessment tools for the 35 ACS/APDS skills modules were identified. Some tools, such as Operative Performance Rating System (OSATS) and Objective Structured Assessment of Technical Skill (OPRS), have been tested for more than 1 procedure. Therefore, 30 modules had at least 1 assessment tool, with some common surgical procedures being addressed by several tools. Five modules had none. Only 3 studies used Messick's framework to design their validity studies. The remaining studies used an outdated framework on the basis of "types of validity." When analyzed using the contemporary framework, few of these studies demonstrated validity for content, internal structure, and relationship to other variables.
  
  
  CONCLUSIONS
  This study provides an assessment toolbox for common surgical skills/procedures. Our review shows that few authors have used the contemporary unitary concept of validity for development of their assessment tools. As we progress toward competency-based training, future studies should provide evidence for various sources of validity using the contemporary framework.
authors.affiliation: *Department of Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC †Department of Surgery, Western University, London, Canada ‡Department of Medical Education, University of Illinois at Chicago, Chicago, IL §American Board of Psychiatry and Neurology, Inc., Deerfield, IL.
authors.forename: Iman
authors.initials: I
authors.lastname: Ghaderi
authors.forename: Farouq
authors.initials: F
authors.lastname: Manji
authors.forename: Yoon Soo
authors.initials: YS
authors.lastname: Park
authors.forename: Dorthea
authors.initials: D
authors.lastname: Juul
authors.forename: Michael
authors.initials: M
authors.lastname: Ott
authors.forename: Ilene
authors.initials: I
authors.lastname: Harris
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Farrell
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods / Q000592:standards; D004521:Educational Measurement / Q000379:methods*; D013502:General Surgery / Q000193:education* / Q000592:standards; D006801:Humans; D015203:Reproducibility of Results; D014481:United States