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Multi-Institutional Development of a Mastoidectomy Performance Evaluation Instrument.

Thomas Kerwin¹, Brad Hittle¹, Don Stredney¹

¹Interface Lab, Ohio Supercomputer Center, Columbus, Ohio.

Journal of Surgical Education

|May 24, 2017

Summary

A multi-institutional expert group developed a surgical performance rating tool for mastoidectomy. Further validation is needed for universal acceptance of this critical surgical skill assessment.

Keywords:

Medical Knowledge Practice-Based Learning and Improvement assessment mastoidectomy multi-institution otology

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Area of Science:

Otolaryngology
Surgical Education
Medical Simulation

Background:

A universal method for rating mastoidectomy surgical performance across teaching institutions is lacking.
This study addresses the need for a standardized assessment tool in otolaryngology training.

Purpose of the Study:

To develop and refine a rating instrument for evaluating mastoidectomy surgical performance.
To create a consensus-based checklist applicable in multi-institutional settings.

Main Methods:

A modified Delphi approach and participatory design were used by expert otologists.
A 15-element checklist was developed, refined to 14 elements focusing on safety, and tested on a diverse performance population.
The study involved 14 surgeons from 12 US otolaryngological training programs.

Main Results:

An initial rating scale for mastoidectomy performance was created using expert consensus and literature review.
Early use indicated moderate rater agreement, leading to revised definitions emphasizing safety.
A second, refined rating instrument was developed based on initial feedback and performance data.

Conclusions:

Consensus-building among experts is effective for creating surgical rating instruments.
Expert opinion and Delphi methods provide initial validity but require further testing for universal acceptance.
Continued development and large-scale validation are essential to establish reliability and widespread use of the mastoidectomy rating tool.