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Objective structured assessment of technical skills for episiotomy repair
Peter E Nielsen1, Lisa M Foglia, Lynn S Mandel
1Department of Obstetrics and Gynecology, Madigan Army Medical Center, MCHJ-OG (ATTN.: LTC Nielsen), Tacoma, WA 98431, USA. Peter.Nielsen@nw.amedd.army.mil
Objective:
This study was undertaken to estimate the reliability and validity of an objective structured assessment of technical skills (OSATS) for midline episiotomy repair using a lifelike anatomic model.
Study Design:
Eighteen residents were administered an episiotomy OSATS. Two evaluators independently completed an objective score sheet assessing six key components of the repair, seven global surgical skills, and a pass/fail score for each resident. Residents also completed an anonymous self-assessment.
Results:
Reliability indices were 0.95 for the checklist and global surgical skills rating. Construct validity found significant differences on the checklist, global surgical skills, and pass/fail score sheets by residency level. Residents more often assessed their own global surgical skills performance lower than the independent evaluators. Surprisingly, 61% (11/18) of the residents failed the assessment, including all postgraduate year 1 and postgraduate year 2 residents.
Conclusion:
Episiotomy OSATS that used task-specific and global checklists provide a reliable and valid method of assessing resident skills in this anatomic model, and performance correlates with resident year level of training.