In-training assessment and predictors of competency in endoscopic sinus surgery

Area of Science:

• Otolaryngology-Head & Neck Surgery
• Surgical Education
• Medical Simulation

Background:

• Assessing surgical competency in real-time is crucial for resident training.
• Existing tools may lack specific metrics for endoscopic sinus surgery (ESS).
• Objective evaluation methods are needed to identify performance gaps.

Purpose of the Study:

• To determine the reliability and validity of an ESS assessment tool for in-training operative competency.
• To identify specific surgical tasks that serve as key indicators of overall performance.
• To enhance the training and evaluation process for surgical residents.

Main Methods:

• A cross-sectional validation study was conducted over 15 months.
• 13 Otolaryngology-Head & Neck Surgery residents (PGY 1-5) were assessed using the ESS tool in the operating room.
• Rhinology faculty scored resident performance using global and checklist components; construct validity was analyzed via ANOVA and regression.

Main Results:

• The ESS assessment tool demonstrated construct validity, with senior residents outperforming junior residents.
• Surgical skill scores improved with increased duration of rhinology rotation.
• "Identification of uncinate and boundaries" emerged as the strongest predictor of overall surgical performance.

Conclusions:

• The ESS assessment tool is a reliable and valid instrument for evaluating surgical competency in the operating room.
• The tool can pinpoint areas needing improvement, allowing for early, targeted interventions.
• This evaluation method supports effective surgical training and competency assessment.