Assessing surgical skill using bench station models.
ABSTRACT The acquisition of surgical skill is one of the essentials of good surgical practice. The training of plastic surgeons is presently unstructured, with few objective measures of surgical skill. The trainee's time to acquire skills may be inadequate because of the shortened time for training with the Calman system. There is also increasing pressure from the government to introduce testing of surgical competency for all surgeons. The authors introduce a series of tasks that allow assessment of technical skill among plastic surgical trainees.
A range of surgeons with differing surgical skill were tested. They performed three tasks designed to assess their ability to suture skin, take a medium-thickness skin graft, and repair a tendon. The candidates were videotaped during the procedures and scored by four independent observers using the Objective Structured Assessment of Technical Skill scoring system. Each candidate was then given an overall competence score.
Sixty-five candidates were tested with an experience range from consultant to junior senior health officer. Results showed significant differences down the grades, with consultants performing the tasks with greater competency than their juniors (p = 0.004).
The authors have demonstrated a valid and reliable method of objectively measuring the surgical skill of plastic surgical trainees. The authors have shown that consultants perform better than the juniors and that the tasks are easily reproduced. This has implications for future assessment in that these tests may be used as formal assessment programs for testing and teaching trainees throughout their careers.
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ABSTRACT: Due to ethical and medical-legal drawbacks, high costs, and difficulties of accessibility that are inherent to the practice of basic surgical skills on living patients, fresh human cadaver, and live animals, the search for alternative forms of training is needed. In this study, the teaching and learning process of basic surgical skills pertinent to plastic surgery during medical education on different inanimate bench models as a form of alternative and complementary training to the teaching programs already established is proposed.Plastic surgery international. 01/2012; 2012:651863.
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ABSTRACT: BACKGROUND: Surgical education is in a period of significant change. Assessment of surgical competency is imprecise compared with cognitive knowledge and judgment. A surgical competency measurement tool may be useful for plastic surgery training programs and certification societies. We present a validation study of a novel measurement instrument for arch bar placement and dental wire handling. METHODS: An Arch Bar Placement Assessment Scale (ABPAS) was created via consensus by 2 craniofacial and 2 maxillofacial surgeons. Residents and faculty members of plastic and maxillofacial surgery (n = 20) then placed an arch bar on the lower jaw of a skull model. Performances were video recorded without revealing identities. Two study groups were created based on subjects experience level: group 1 (n = 10) previously placed fewer than 25 arch bars; group 2 (n = 10) previously placed more than 25 arch bars. Two craniofacial surgeons used the ABPAS to blindly grade surgical performance. RESULTS: The ABPAS consisted of a 48-point rating scale that included a 23-point task-specific work list and a 25-point global rating scale. Pearson coefficient showed limited intraobserver (P = 0.97) and interobserver (P = 0.95) variance of test scores. The ABPAS demonstrated superior performance in group 2 in the task-specific work list [12.6 (5.5) vs 17.6 (1.5), P = 0.02], global rating scale [17.4 (4.4) vs 22 (2.1), P = 0.01], and ABPAS score [30 (9.8) and 39.6 (3.2), P = 0.01]. CONCLUSIONS: The ABPAS is a novel measurement tool which assesses technical surgical skill and can identify surgical competency in arch bar placement and dental wire handling. This tool may have future use in residency training and continuing education.Annals of plastic surgery 06/2013; · 1.29 Impact Factor
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ABSTRACT: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.Indian Journal of Dermatology 05/2013; 58(3):200-7.