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Related Experiment Video

Updated: Feb 20, 2026

Endaural Endoscopic Atticoantrotomy Retrograde Mastoidectomy using a Constant Suction Bone-drilling Technique
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Cross-Institutional Evaluation of a Mastoidectomy Assessment Instrument.

Thomas Kerwin1, Brad Hittle1, Don Stredney1

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

Journal of Surgical Education
|October 29, 2017
PubMed
Summary

This study validated a checklist for evaluating mastoidectomy performance. A high score is necessary but not sufficient for expert-level surgical skill assessment.

Keywords:
Medical KnowledgePractice-Based Learning and Improvementassessmentmastoidectomysurgical performance evaluationvirtual reality simulation

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Area of Science:

  • Otolaryngology
  • Surgical Education
  • Medical Simulation

Background:

  • Mastoidectomy is a complex surgical procedure.
  • Objective assessment of surgical skill is crucial for training and patient safety.
  • Existing evaluation instruments may require further validation.

Purpose of the Study:

  • To gather validity evidence for a mastoidectomy performance evaluation instrument.
  • To assess the reliability and utility of a task-based checklist for surgical skill assessment.
  • To explore necessary conditions for expert-level performance in mastoidectomy.

Main Methods:

  • Surgical performances were simulated on a virtual temporal bone system.
  • Experts rated performances using a 15-element task-based checklist.
  • A second checklist was developed and used for further rating rounds.

Main Results:

  • Intraclass correlation scores varied across checklist items.
  • High scores on the checklist were found to be necessary, but not sufficient, for expert-level mastoidectomy performance.
  • Rewording items for safety did not improve instrument reliability.

Conclusions:

  • The task-based checklist provides validity evidence for assessing mastoidectomy performance.
  • Necessary Condition Analysis offers deeper insights into surgical skill grading.
  • A multi-point scale with descriptive mastery levels is recommended over binary pass/fail assessments.