Abstract
Background. Evaluation of surgical competency should include assessment of knowledge, technical
skill, and judgment. The purpose of this study was to determine the relationship between
the American Board of Surgery In-Training Examination (ABSITE), skill testing, and
intraoperative assessment. Methods. Postgraduate year 2 (PGY-2) and postgraduate year 3 (PGY-3) surgery residents (n
= 33) were tested by means of (1) the ABSITE, (2) skill testing on a laparoscopic
video-trainer, and (3) intra-operative global assessments during laparoscopic cholecystectomy.
The Pearson correlation was used to determine the correlation between the ABSITE,
skill testing, and intraoperative assessments. For the comparison of PGY-2 and PGY-3
resident performance, Wilcoxon rank sum tests were used. Results. The ABSITE scores did not correlate with skill testing or intraoperative assessments
(not significant). Skill testing correlated with the intraoperative composite score
and with 4 of 8 operative performance criteria (P <.05). The ABSITE scores and skill testing were not different for PGY-2 and PGY-3
residents (not significant). Intraoperative assessments were better in 5 of 8 criteria
and the composite score for PGY-3 versus PGY-2 residents (P <.05), which demonstrated construct validity. Conclusions. The ABSITE measures knowledge but does not correlate with technical skill or operative
performance. Residency programs should use multiple assessment instruments to evaluate
competency. There may be a role for both skill testing and intraoperative assessment
in the evaluation of surgical competency. (Surgery 2000;128:613-22)
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- External regulation, resident performance, and quality improvement.Curr Surg. 1994; 51: 447-450
- The necessity, practicality, and feasibility of modern educational and evaluative methods for residency training: economic and governing body perspectives, the 1994 Association for Academic Surgery panel on education.Curr Surg. 1997; 54: 261-269
- The financial impact of teaching surgical residents in the operating room.Am J Surg. 1999; 177: 28-32
- Competency-based instruction in critical invasive skills improves both resident performance and patient safety.Surgery. 1998; 124: 313-317
- The American Board of Surgery in-training examination.Arch Surg. 1980; 115: 654-657
- The relationship between faculty ward evaluations, OSCE, and ABSITE as measures of surgical intern performance.Am J Surg. 1995; 169: 414-417
- Assessing residents' clinical performance: cumulative results of a four-year study with the Objective Structured Clinical Examination.Surgery. 1998; 124: 307-312
- Assessment of technical skills transfer from the bench training model to the human model.Am J Surg. 1999; 177: 167-170
- Objective structured assessment of technical skill (OSATS) for surgical residents.Br J Surg. 1997; 84: 273-278
- Testing technical skill via an innovative “bench Station” examination.Am J Surg. 1996; 173: 226-230
- Reliability and construct validity of a structured technical skills assessment form.Am J Surg. 1994; 167: 423-427
- Intense laparoscopic skills training improves operative performance of surgery residents.in: American College of Surgeons Surgical Forum. L. 1999: 670-671
- Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons.Arch Surg. 1998; 133: 657-661
- The influence of three-dimensional video systems on laparoscopic task performance.Surg Laparosc Endosc. 1996; 6: 191-197
- A methodological framework for the design of research on the evaluation of residents.Acad Med. 1990; 65: 36-41
- Assessing clinical competence at the undergraduate level.Med Educ. 1992; 26: 504-511
- The American Board of Surgery In-training Examination as a predictor of success on the Qualifying Examination.Curr Surg. 1987; 44: 194-198
- Dimensionality, internal consistency, and interrater reliability of clinical performance ratings.Med Educ. 1987; 21: 130-137
- Comparison of edited videotape to direct observation to assess operative performance after laparoscopic skills training.J Surg Res. 1999; 86 ([abstract]): 291
- Development of a model for training and evaluation of laparoscopic skills.Am J Surg. 1998; 175: 482-487
- Assessment of innate ability and skills for endoscopic manipulations by the advanced Dundee endoscopic psychomotor tester: predictive and concurrent validity.Am J Surg. 1999; 177: 274-277
- Medical students learn more than residents during structured laparoscopic skills training.Surg Endosc. 2000; 14 ([abstract]): S217
Bergen PC, Littlefield JH, O'Keefe GE, Rege RV, Anthony TA, Kim LT, et al. Identification of high-risk residents. J Surg Res. In press.
Article info
Footnotes
*Funding was provided by the Southwestern Center for Minimally Invasive Surgery as supported in part by an educational grant from United States Surgical—a Division of Tyco Healthcare Group. The video-trainer was provided by Karl Storz Endoscopy. Statistical analysis was performed by William H. Frawley, PhD, Department of Academic Computing, University of Texas Southwestern Medical Center.
**Reprint requests: Daniel B. Jones, MD, Assistant Professor, Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-9092.
★Surgery 2000;128:613-22
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
