title: Consensus-based training and assessment model for general surgery.
abstract: BACKGROUND
  Surgical education is becoming competency-based with the implementation of in-training milestones. Training guidelines should reflect these changes and determine the specific procedures for such milestone assessments. This study aimed to develop a consensus view regarding operative procedures and tasks considered appropriate for junior and senior trainees, and the procedures that can be used as technical milestone assessments for trainee progression in general surgery.
  
  
  METHODS
  A Delphi process was followed where questionnaires were distributed to all 17 Canadian general surgery programme directors. Items were ranked on a 5-point Likert scale, with consensus defined as Cronbach's α of at least 0·70. Items rated 4 or above on the 5-point Likert scale by 80 per cent of the programme directors were included in the models.
  
  
  RESULTS
  Two Delphi rounds were completed, with 14 programme directors taking part in round one and 11 in round two. The overall consensus was high (Cronbach's α = 0·98). The training model included 101 unique procedures and tasks, 24 specific to junior trainees, 68 specific to senior trainees, and nine appropriate to all. The assessment model included four procedures.
  
  
  CONCLUSIONS
  A system of operative procedures and tasks for junior- and senior-level trainees has been developed along with an assessment model for trainee progression. These can be used as milestones in competency-based assessments.
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Szasz
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Louridas
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Canada.
authors.forename: S
authors.initials: S
authors.lastname: de Montbrun
authors.affiliation: Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.
authors.forename: K A
authors.initials: KA
authors.lastname: Harris
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Canada.
authors.forename: T P
authors.initials: TP
authors.lastname: Grantcharov
mesh_terms: D002170:Canada; D002983:Clinical Competence; D032921:Consensus; D003697:Delphi Technique; D004503:Education, Medical, Graduate / Q000379:methods*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D013043:Specialties, Surgical / Q000193:education*