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Reliable assessment of operative performance
Elif Bilgic1, Yusuke Watanabe2, Katherine McKendy1
1Department of Surgery, Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Avenue, D6-257, Montreal, QC, H3G1A4, Canada.
American Journal of Surgery
|December 19, 2015
Summary
Generalizability theory (GT) indicates that at least 3 laparoscopic surgery cases are needed for reliable trainee performance assessment using the Global Operative Assessment of Laparoscopic Skills (GOALS) tool. Trainees significantly influence score variance.
Area of Science:
- Surgical Education Research
- Medical Simulation
- Performance Measurement
Background:
- Lack of consensus on reliable intraoperative assessment methods for surgical trainees.
- Generalizability theory (GT) offers a framework to analyze score variance in performance evaluations.
Purpose of the Study:
- To apply GT to identify factors contributing to score variance in laparoscopic skill assessments.
- To determine the optimal number of assessments for reliable trainee performance evaluation.
Main Methods:
- Prospective data collection of laparoscopic procedure assessments using Global Operative Assessment of Laparoscopic Skills (GOALS).
- Trainees were assessed multiple times by attending surgeons over 2-month intervals.
- Reliability coefficients were calculated considering trainees, cases, and raters as factors.
Main Results:
- Eighteen trainees and 65 assessments were analyzed.
- Trainee performance accounted for the largest score variance (66.1%).
- A minimum of 3 cases are required for reliable GOALS scores, with minimal variance attributed to raters (2.3%).
Conclusions:
- Trainee performance is the primary source of variance in GOALS scores.
- Implementing at least 3 cases per trainee enhances the reliability of performance assessments.
- Findings can inform the design of robust surgical training and assessment programs.
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