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Assessment of progress and competence in tonsillectomy surgery using cumulative sum analysis
A K Abou-Foul1, A Taghi1, N S Tolley1
1Department of Otolaryngology, Head and Neck Surgery,Imperial College Healthcare NHS Trust,London,UK.
The Journal of Laryngology and Otology
|July 13, 2018
Summary
Cumulative sum analysis effectively monitors surgical training progress. This method highlights trainee performance curves in tonsillectomy, enabling early detection of concerns and intervention.
Area of Science:
- Medical Education
- Surgical Training
- Quality Improvement
Background:
- Tonsillectomy is a common surgical procedure.
- Monitoring surgical trainee performance is crucial for patient safety and skill development.
- Objective metrics are needed to assess competence in otolaryngology trainees.
Purpose of the Study:
- To evaluate the feasibility of using cumulative sum (CUSUM) analysis for monitoring otolaryngology trainees' performance in tonsillectomy.
- To assess CUSUM analysis's ability to identify performance trends and potential issues during surgical training.
Main Methods:
- A prospective study comparing eight otolaryngology trainees with expert surgeons.
- Performance was evaluated based on operative time and post-operative complications.
- Cumulative sum analysis charts were generated and updated after each case to visualize performance trends.
Main Results:
- Trainees had significantly longer operative times (38 min) compared to experts (23 min) (p < 0.0001).
- CUSUM charts for trainees' operative time showed an initial rise followed by a plateau around 25-30 cases.
- CUSUM charts demonstrated potential for monitoring complications, although low incidence required combining outcomes.
Conclusions:
- Cumulative sum analysis is a flexible and sensitive tool for monitoring surgical training.
- It serves as a valuable adjunct for assessing trainee progress and competence in otolaryngology.
- CUSUM analysis facilitates early identification of suboptimal performance, allowing for timely intervention.
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