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Operative performance in laparoscopic cholecystectomy using the Procedural-Based Assessment tool.

Sudip K Sarker1, M Maciocco, A Zaman

  • 1Whittington Hospital, London, UK. s.sarker@doctors.org.uk

American Journal of Surgery
|June 25, 2010
PubMed
Summary

The Procedural-Based Assessment (PBA) tool reliably assesses generic technical skills in surgical trainees during both simulated and live laparoscopic cholecystectomies. It demonstrates good validity for generic skills and specific skills in unsupervised simulations.

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Area of Science:

  • Surgical Education
  • Medical Simulation
  • Assessment Tools

Background:

  • The Intercollegiate Surgical Curriculum Project (ISCP) developed assessment tools to evaluate surgical trainee technical skills.
  • The Procedural-Based Assessment (PBA) is a tool designed for evaluating index operations performed by surgical trainees.

Purpose of the Study:

  • To evaluate the reliability and validity of the Procedural-Based Assessment (PBA) tool in assessing surgical trainee technical skills.
  • To determine if the PBA tool is effective for both live supervised and simulated unsupervised laparoscopic cholecystectomies.

Main Methods:

  • Trainees performed live and simulated laparoscopic cholecystectomies.
  • Two experienced surgeons independently and blindly assessed each operation using the PBA tool.

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  • Inter-rater reliability and construct validity for generic and specific technical skills were analyzed.

    • Main Results:

    • High inter-rater reliability was observed (kappa = .86 for live, .84 for simulated operations).
    • The PBA demonstrated construct validity for generic technical skills in both live and simulated settings (P < .05).
    • Construct validity for specific technical skills was found only in simulated unsupervised operations (P < .05).

    Conclusions:

    • The PBA tool exhibits good inter-rater reliability.
    • The PBA is a valid assessment tool for generic technical skills in both simulated and live laparoscopic cholecystectomies.
    • The PBA effectively assesses specific technical skills in unsupervised simulated settings.