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Scoping Evidence Review on Training and Skills Assessment for Open Emergency Surgery
Colin F Mackenzie1, Eric A Elster2, Mark W Bowyer2
1Shock Trauma Anesthesiology Research Center, Baltimore, Maryland.
Journal of Surgical Education
|April 1, 2020
Summary
Technical performance metrics for open emergency surgery are limited. The Individual Procedure Score (IPS) can identify surgeons needing remediation, but no metrics show training benefits for patient outcomes.
Area of Science:
- Surgical Education
- Medical Simulation
- Trauma Surgery
Background:
- Assessing technical skills in open emergency surgery is crucial for patient safety.
- Existing metrics often lack validation for high-stakes trauma and vascular procedures.
Purpose of the Study:
- To review evidence on technical performance metrics for open emergency surgery.
- To identify metrics and procedures used in trauma surgical training.
Main Methods:
- Systematic literature searches of electronic databases (Jan 2010-Dec 2019).
- Included systematic reviews evaluating surgical skills assessment tools in vascular or trauma surgery.
Main Results:
- Objective Structured Assessment of Technical Skill (OSATS) is not used for emergency trauma surgery.
- Individual Procedure Score (IPS) differentiated resident from expert performance and identified surgeons needing remediation.
- No metrics demonstrated Kirkpatrick's Level 4 evidence for improved emergency surgery outcomes.
Conclusions:
- Expert benchmarks, error rates, complication rates, task completion time, checklists, global rating scales, OSATS, and IPS can identify surgeons requiring technical skills remediation for hemorrhage control.
- Large-scale, multicenter studies are needed to assess the impact of trauma technical skills training on patient outcomes.
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