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Updated: Jun 27, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Objective structured assessment of technical skills for repair of fourth-degree perineal lacerations
Nazema Y Siddiqui1, Kevin J Stepp, Susan J Lasch
1Division of Urogynecology and Reconstructive Pelvic Surgery, Duke University Medical Center, Durham, NC, USA.
Objective:
The objective of this study was to assess the reliability and validity of an objective structured assessment of technical skills (OSATS) for repair of fourth-degree obstetric lacerations on a surgical model.
Study Design:
Three blinded judges reviewed recordings of 20 junior and 20 senior obstetrics-gynecology residents performing simulated perineal repairs using a beef tongue model. Judges completed task-specific OSATS and global rating scales for each repair. Six recordings were rereviewed after 2 weeks. Inter- and intrarater reliability and construct validity were assessed.
Results:
Interrater reliability was 0.80 for task-specific OSATS and 0.59 for the global rating scale. Intrarater reliability was poor. Construct validity was demonstrated, with senior residents scoring higher than junior residents on task-specific OSATS (13.0 vs 10.5; P = .007) and the global rating scale (24.0 vs 19.3; P = .001).
Conclusion:
We found good interrater reliability and construct validity using a task-specific OSATS for fourth-degree perineal laceration repair. This instrument shows promise as a tool for competency-based evaluations.
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