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Validity: applying current concepts and standards to gynecologic surgery performance assessments.
Edgar L LeClaire1, Mikio A Nihira, Patricia L Hardré
1Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Kansas School of Medicine-Wichita, 551 North Hillside, Suite 500, Wichita, KS, 67214, USA, edgar.leclaire@gmail.com.
Surgical competency assessments in gynecology often lack robust validity evidence, primarily relying on generalizability. Improved adherence to standards and systematic validation arguments are crucial for accurate surgical performance evaluation.
Area of Science:
- Medical Education
- Surgical Assessment
- Psychometrics
Background:
- Validity is essential for accurate surgical competency assessment.
- The Standards for Educational and Psychological Testing mandate integrating diverse evidence for validation.
- Construct validity claims require comprehensive supporting data.
Purpose of the Study:
- To develop a method for categorizing validity evidence in surgical performance assessments.
- To analyze validity evidence in gynecologic surgery literature from 2000-2012.
Main Methods:
- Critical analysis of published observations on construct validity in gynecologic surgery.
- Literature search of Medline and Embase databases (2000-2012).
- Development and application of categorization criteria by researchers, with independent evaluator review and weighted kappa for inter-rater agreement.
Main Results:
- Twenty-five articles were analyzed; 72% defined construct validity by proficiency discrimination.
- Identified 80 validity evidence observations: 30% focused on proficiency levels, 25% on scoring models, 14% on content.
- No studies reported statistical correlation between assessment scores and objective surgical outcomes; test-criterion evidence was absent.
Conclusions:
- Gynecologic surgical assessment validity claims predominantly rely on generalizability evidence.
- A significant gap exists in reporting test-criterion evidence.
- Enhanced awareness of current validation standards and systematic argument development is necessary.
