title: Self-assessment in laparoscopic surgical skills training: Is it reliable?
abstract: The concept of self-assessment has been widely acclaimed for its role in the professional development cycle and self-regulation. In the field of medical education, self-assessment has been most used to evaluate the cognitive knowledge of students. The complexity of training and evaluation in laparoscopic surgery has previously acted as a barrier in determining the benefits self-assessment has to offer in comparison with other fields of medical education.
  
  
  
  Thirty-five surgical residents who attended the 2-day Laparoscopic Surgical Skills Grade 1 Level 1 curriculum were invited to participate from The Netherlands, India and Romania. The competency assessment tool (CAT) for laparoscopic cholecystectomy was used for self- and expert-assessment and the resulting distributions assessed.
  
  
  
  A comparison between the expert- and self-assessed aggregates of scores from the CAT agreed with previous studies. Uniquely to this study, the aggregates of individual sub-categories-'use of instruments'; 'tissue handling'; and errors 'within the component tasks' and the 'end product' from both self- and expert-assessments-were investigated. There was strong positive correlation (rs> 0.5; p < 0.001) between the expert- and self-assessment in all categories with only the 'tissue handling' having a weaker correlation (rs= 0.3; p = 0.04). The distribution of the mean of the differences between self-assessment and expert-assessment suggested no significant difference between the scores of experts and the residents in all categories except the 'end product' evaluation where the difference was significant (W = 119, p = 0.03).
  
  
  
  Self-assessment using the CAT form gives results that are consistently not different from expert-assessment when assessing one's proficiency in surgical skills. Areas where there was less agreement could be explained by variations in the level of training and understanding of the assessment criteria.
authors.affiliation: Delft University of Technology, Industrial Design Engineering, Medisign, Delft, The Netherlands. s.ganni@tudelft.nl.|Department of Surgery, GSL Medical College, Rajahmundry, India. s.ganni@tudelft.nl.|Research and Education, Catharina Hospital, Michelangelolaan 2, 5653 EJ, Eindhoven, The Netherlands. s.ganni@tudelft.nl.
authors.forename: Sandeep
authors.identifier: 0000-0003-2253-0566
authors.initials: S
authors.lastname: Ganni
authors.affiliation: Delft University of Technology, Industrial Design Engineering, Medisign, Delft, The Netherlands.
authors.forename: Magdalena K
authors.initials: MK
authors.lastname: Chmarra
authors.affiliation: Delft University of Technology, Industrial Design Engineering, Medisign, Delft, The Netherlands.
authors.forename: Richard H M
authors.initials: RHM
authors.lastname: Goossens
authors.affiliation: Delft University of Technology, Industrial Design Engineering, Medisign, Delft, The Netherlands.|Research and Education, Catharina Hospital, Michelangelolaan 2, 5653 EJ, Eindhoven, The Netherlands.
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Jakimowicz
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007194:India; D007396:Internship and Residency; D008297:Male; D009426:Netherlands; D012383:Romania; D012647:Self-Assessment
keywords: Evaluation; Expert-assessment; Laparoscopic cholecystectomy; Laparoscopic skills; Self-assessment; Training