title: Design and validation of the surgical ward round assessment tool: a quantitative observational study.
abstract: BACKGROUND
  Ward round skills are essential for the best management of surgical inpatients, but assessment of their quality has received inadequate attention. This study aims to design and validate the surgical ward round assessment tool (SWAT).
  
  
  METHODS
  We used modified Healthcare Failure Mode and Effects Analysis to develop the SWAT by identifying ward round steps. We assessed the validity of the SWAT using simulated and real surgical ward rounds.
  
  
  RESULTS
  The Healthcare Failure Mode and Effects Analysis identified 30 ward round steps that were developed into the SWAT. Nineteen surgeons completed simulated surgical ward rounds. Eight fully trained surgeons scored significantly higher than 11 trainee surgeons when assessed with the SWAT (P = .001). On average, the participants thought the realism of the simulation was good. Forty-four surgeons completed real surgical ward rounds. Fifteen experts scored significantly higher than 29 trainee surgeons when assessed with SWAT (P = .001). Inter-rater reliability was .85 to .89, respectively.
  
  
  CONCLUSIONS
  The SWAT can be used to assess the quality of task-based and nontechnical surgical ward round skills.
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, QEQM Wing, St Mary's Hospital, London W2 1NY, UK; MRC Centre for Transplantation, King's College London, Guy's Hospital, London SE1 9RT, UK.
authors: Kamran
authors: K
authors: Ahmed
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, QEQM Wing, St Mary's Hospital, London W2 1NY, UK.
authors: Oliver
authors: O
authors: Anderson
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, QEQM Wing, St Mary's Hospital, London W2 1NY, UK.
authors: Muhammad
authors: M
authors: Jawad
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, QEQM Wing, St Mary's Hospital, London W2 1NY, UK.
authors: Tanya
authors: T
authors: Tierney
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, QEQM Wing, St Mary's Hospital, London W2 1NY, UK.
authors: Ara
authors: A
authors: Darzi
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, QEQM Wing, St Mary's Hospital, London W2 1NY, UK.
authors: Thanos
authors: T
authors: Athanasiou
authors: Department of Surgery and Cancer, Imperial College London, 10th Floor, QEQM Wing, St Mary's Hospital, London W2 1NY, UK. Electronic address: g.hanna@imperial.ac.uk.
authors: George B
authors: GB
authors: Hanna
mesh_terms: D002983:Clinical Competence; D005069:Evaluation Studies as Topic; D006761:Hospitals; D006801:Humans; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000193:education*; D056164:Teaching Rounds
keywords: Assessment; Simulation; Surgery; Training; Ward round