title: Do errors and critical events relate to hernia repair outcomes?
abstract: BACKGROUND
  The study aimed to validate an error checklist for simulated laparoscopic ventral hernia (LVH) repair procedures. We hypothesize that residents' errors can be assessed with a structured checklist and the results will correlate significantly with procedural outcomes.
  
  
  METHODS
  Senior residents' (N = 7) performance on a LVH simulator were video-recorded and analyzed using a human error checklist. Junior residents (N = 38) performed two steps of the same simulated LVH procedure. Performance was evaluated using the error checklist and repair quality scores.
  
  
  RESULTS
  There were no significant differences between senior and junior residents' checklist errors (p > 0.1). Junior residents' errors correlated with hernia repair quality (p = 0.05).
  
  
  CONCLUSIONS
  The newly developed assessment tool showed significant correlations between performance errors, critical events, and hernia repair quality. These results provide validity evidence for the use of errors in performance assessments.
  
  
  CONCLUSIONS
  This study validated an error checklist for simulated laparoscopic ventral hernia (LVH) repair procedures. The checklist was designed based on errors committed by chief surgery residents during LVH repairs. In a separate data collection, junior residents were evaluated using the checklist. Hernia repair quality was also assessed. Errors significantly correlated with hernia repair quality (p = 0.05).
authors.affiliation: University of Wisconsin-Madison, School of Engineering, Department of Industrial and Systems Engineering, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Law Forsyth
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: DiMarco
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Caitlin G
authors.initials: CG
authors.lastname: Jenewein
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Rebecca D
authors.initials: RD
authors.lastname: Ray
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Anne-Lise D
authors.initials: AD
authors.lastname: D'Angelo
authors.affiliation: University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
authors.forename: Elaine R
authors.initials: ER
authors.lastname: Cohen
authors.affiliation: University of Wisconsin-Madison, School of Engineering, Department of Industrial and Systems Engineering, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Wiegmann
authors.affiliation: University of Wisconsin-Madison, School of Engineering, Department of Industrial and Systems Engineering, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA; University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA. Electronic address: pugh@surgery.wisc.edu.
authors.forename: Carla M
authors.initials: CM
authors.lastname: Pugh
mesh_terms: D057189:Checklist; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D013502:General Surgery / Q000193:education; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D019300:Medical Errors; D000066908:Simulation Training
keywords: Assessment; Decision-making; Laparoscopy; Simulation; Surgical education; Surgical error