title: An objective assessment tool for basic surgical knot-tying skills.
abstract: OBJECTIVE
  To determine if a knot-tying checklist can provide a valid score and if the checklist can be used by novice surgeons in a reliable manner.
  
  
  METHODS
  This study was conducted at the Surgical Skills Center at the University of California, San Francisco. A knot-tying checklist was developed from a kinesthetic knot-tying curriculum. Novice (67 first-year medical students) and experienced surgeons (8 residents postgraduate year 3 and higher and 2 attending physicians) were videotaped performing 4 knot-tying tasks, and the videotapes were rated with a global score and a checklist by interns (n = 3) and experienced (n = 3) surgeons.
  
  
  RESULTS
  Both interns and experienced surgeons can use the knot-tying checklist with acceptable reliabilities (>0.8 with 3 raters). The checklist is able to differentiate between novice and experienced surgeons, when used by both interns and experienced raters. The expert knot-tying score correlated with the global score overall (r = 0.88) and for each task (r was 0.82 for task 1, 0.85 for task 2, 0.80 for task 3, and 0.81 for task 4).
  
  
  CONCLUSIONS
  The knot-tying checklist provides a valid score for basic surgical knot-tying and can be used by novice and experienced raters. Its use supports peer assessment of performance in a surgical skills laboratory setting.
authors.affiliation: Department of Surgery, University of California San Francisco, San Francisco, California.
authors.forename: Emily
authors.initials: E
authors.lastname: Huang
authors.affiliation: Department of Surgery, University of California San Francisco, San Francisco, California. Electronic address: Carolyn.vaughn@ucsfmedctr.org.
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Vaughn
authors.affiliation: Department of Surgery, University of California San Francisco, San Francisco, California.
authors.forename: Hueylan
authors.initials: H
authors.lastname: Chern
authors.affiliation: Department of Medicine and Surgery, University of California San Francisco, San Francisco, California.
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Sullivan
authors.affiliation: Department of Surgery, University of California San Francisco, San Francisco, California.
authors.forename: Edward
authors.initials: E
authors.lastname: Kim
mesh_terms: D057189:Checklist; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate; D004521:Educational Measurement / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D011594:Psychometrics; D012495:San Francisco; D012647:Self-Assessment; D013536:Suture Techniques / Q000592:standards*; D014743:Videotape Recording
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; checklist; knot tying; medical education; surgical skills; validated assessment