Assessing Operative Competency in Cochlear Implantation Across the Residency Training Continuum

Area of Science:

• Otolaryngology-Head and Neck Surgery
• Surgical Education
• Medical Simulation

Background:

• Assessing surgical competency is crucial for resident training in otolaryngology.
• Objective metrics are needed to evaluate proficiency in complex procedures like cochlear implantation.
• Existing assessment tools require validation for specific surgical skills.

Purpose of the Study:

• To derive normative data for cochlear implant surgical competency assessment.
• To establish benchmarks based on postgraduate year (PGY) and otology rotation completion.
• To validate an assessment tool for otologic surgical skills.

Main Methods:

• Prospective, blinded validation study.
• Utilized a validated assessment tool in a temporal bone laboratory.
• Assessed 14 otolaryngology trainees (PGY-1 to PGY-6) 26 times.
• Measured construct validity, internal consistency, and inter-rater reliability.

Main Results:

• Excellent inter-rater reliability (Cohen's kappa = 0.82).
• Positive association between higher PGY/otology rotations and improved surgical competency scores.
• Inverse association between PGY/otology rotations and exercise completion time.

Conclusions:

• The validated instrument reliably assesses surgical competency in cochlear implantation for residents.
• Normative data can guide objective feedback and identify deficiencies early in training.
• Supports targeted interventions for surgical skill development.