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Systematic review to establish absolute standards for technical performance in surgery.

M G Goldenberg1, A Garbens1, P Szasz1

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Absolute standard-setting methods effectively establish benchmarks for assessing technical and procedural skills in medical education. This systematic review confirms their utility in differentiating performance levels for various healthcare professionals.

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Area of Science:

  • Medical Education
  • Assessment Methodology
  • Skill Evaluation

Background:

  • Standard setting creates benchmarks for assessment, differentiating between passing and failing performance.
  • It is applicable for establishing standards in clinical and simulated procedural skills.
  • This review focuses on absolute standard-setting methodology for technical performance benchmarks.

Purpose of the Study:

  • To systematically review the literature on absolute standard-setting methodology for technical performance benchmarks.
  • To identify and evaluate studies using these methods in procedural skill assessment.

Main Methods:

  • A systematic review of MEDLINE, Embase, PsycINFO, and Cochrane Database of Systematic Reviews.
  • Inclusion criteria applied to abstracts, followed by full-text review.
  • Study quality assessed using the Medical Education Research Study Quality Instrument (MERSQI).

Main Results:

  • 37 studies utilized standard-setting for procedural skill assessment; 24 participant-centered, 13 item-centered.
  • Most studies (30/37) were in simulated environments, assessing residents, fellows, and staff physicians.
  • 17 studies met the high-quality evidence threshold (MERSQI ≥ 14/18).

Conclusions:

  • Absolute standard-setting methodologies are effective for establishing performance cut-offs in procedural skill assessments.
  • These methods provide a reliable framework for evaluating technical proficiency in healthcare professionals.