Rapid assessment of technical competency: the 8-min suture test.
BACKGROUND
Although simulation training and evaluation have become increasingly popular for teaching minimally invasive surgery, tools to measure open surgical skills remain underdeveloped. As there is increasing demand for objective measures of technical competency at the completion of surgical training (postgraduate year [PGY]-6 and -7), this project was designed to assess the feasibility, reliability, and validity of a novel open surgical skills evaluation tool, the 8-min suture test (8MST).


METHODS
During an annual surgical skills laboratory session, fellows and residents were asked to complete a simulated end-to-end vascular anastomosis. They were limited to 8 min to perform the anastomosis between two 12-mm Dacron grafts mounted on a customized platform. Their real-time and video-recorded performance was scored by two blinded evaluators and compared with their faculty-rated technical performance on clinical rotations completed around the time of 8MST administration.


RESULTS
PGY-6 and PGY-7 trainees were compared across several domains including 8MST total score (4.6 versus 5.5, P = 0.030), 8MST setup score (2.3 versus 2.4, P = 0.797), 8MST technical score (2.3 versus 3.1, P = 0.026), and clinical performance score (3.1 versus 3.6, P = 0.006). Comparison of 8MST total score to the clinical performance score identified a strong relationship with a Pearson r = 0.55 (P < 0.001) and r(2) = 0.30. Additionally, 8MST displayed high inter-rater reliability and test-retest reliability.


CONCLUSIONS
The 8MST is a rapid, feasible, inexpensive, reliable, and valid test for assessment of surgical trainee technical abilities.
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ryan W
RW
Day
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jason
J
Fleming
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Matthew H
MH
Katz
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Elizabeth
E
Grubbs
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Brian K
BK
Bednarski
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jeffrey E
JE
Lee
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: taaloia@mdanderson.org.
Thomas A
TA
Aloia
D019917:Blood Vessel Prosthesis Implantation / Q000193:education; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005240:Feasibility Studies; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D015203:Reproducibility of Results; D016037:Single-Blind Method; D013536:Suture Techniques / Q000193:education*; D013781:Texas
8MST; Advanced training; Simulation; Surgical education; Technical skill; Testing