Accuracy of medical staff assessment of trainees' operative performance

The aim of this study was to determine the accuracy of medical staff assessment of trainees' operative competence. Over 18 months all 36 basic surgical trainees in SE Scotland were evaluated at the end of each attachment by consultants and registrars on their ability to perform key operative procedures using a previously validated assessment form. Frequency of assessment was compared with: (1) trainee's recording of whether the specific assessor had actually directly supervised them performing the procedure and (2) number of supervised procedures performed by trainees as determined by logbook data. A high percentage of both assessor groups provided assessment of procedures which they had not observed. Only 19/102 consultants and 20/95 registrars assessed only those procedures directly observed. A median of 9% (range 0-54%) of staff provided assessment for procedures that trainees had never even performed during that attachment. Such discrepancy needs to be addressed if accurate assessment of competence is to be achieved by trainers.