Related Experiment Video
Updated: Mar 27, 2026
Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Implementing and Evaluating a National Certification Technical Skills Examination: The Colorectal Objective
Sandra de Montbrun1, Patricia L Roberts, Lisa Satterthwaite
1*Department of Surgery, University of Toronto, Division of General Surgery, St. Michael's Hospital Toronto, Toronto, Ontario, Canada†Division of Surgery Lahey Clinic, Tufts University School of Medicine, Burlington, MA‡University of Toronto, Surgical Skills Centre, Mount Sinai Hospital, Toronto, Ontario, Canada§Department of Surgery, University of Toronto, Division of General Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
Objective:
To implement the Colorectal Objective Structured Assessment of Technical skill (COSATS) into American Board of Colon and Rectal Surgery (ABCRS) certification and build evidence of validity for the interpretation of the scores of this high stakes assessment tool.
Background Data:
Currently, technical skill assessment is not a formal component of board certification. With the technical demands of surgical specialties, documenting competence in technical skill at the time of certification with a valid tool is ideal.
Methods:
In September 2014, the COSATS was a mandatory component of ABCRS certification. Seventy candidates took the examination, with their performance evaluated by expert colorectal surgeons using a task-specific checklist, global rating scale, and overall performance scale. Passing scores were set and compared using 2 standard setting methodologies, using a compensatory and conjunctive model. Inter-rater reliability and the reliability of the pass/fail decision were calculated using Cronbach alpha and Subkoviak methodology, respectively. Overall COSATS scores and pass/fail status were compared with results on the ABCRS oral examination.
Results:
The pass rate ranged from 85.7% to 90%. Inter-rater reliability (0.85) and reliability of the pass/fail decision (0.87 and 0.84) were high. A low positive correlation (r= 0.25) was seen between the COSATS and oral examination. All individuals who failed the COSATS passed the ABCRS oral examination.
Conclusions:
COSATS is the first technical skill examination used in national surgical board certification. This study suggests that the current certification process may be failing to identify individuals who have demonstrated technical deficiencies on this standardized assessment tool.
More Related Videos
06:28E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
07:31A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills
Published on: February 13, 2020
Related Concept Videos
01:25Endoscopic Procedures II: Colonoscopy
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...