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Published on: March 23, 2019
Are Video Recordings Reliable for Assessing Surgical Performance? A Prospective Reliability Study Using
Andreas Frithioff1, Martin Frendø, Søren Foghsgaard
1From the Copenhagen Hearing and Balance Center, Department of Otorhinolaryngology-Head & Neck Surgery and Audiology (A.F., M.F., S.F., M.S., S.A.W.A.), Rigshospitalet, Copenhagen; and Copenhagen Academy for Medical Education and Simulation (CAMES; A.F., M.F., S.A.W.A.), Center for HR & Education, Copenhagen, Denmark.
Video-based and physical surgical skills assessments demonstrate equal reliability. Rater performance was unaffected by assessment modality, suggesting distinct physical or video-based evaluations are optimal.
Area of Science:
- Medical Education
- Surgical Training
- Assessment Methodology
Background:
- Surgical skills assessment is crucial for patient safety.
- Video-based assessment offers objective evaluation without physical assessor presence.
- Reliability of video-based surgical assessment requires further investigation.
Purpose of the Study:
- To compare the reliability of video-based versus physical assessment of surgical skills.
- To evaluate performance on 3D-printed models and human cadavers.
- To determine optimal rater and performance numbers for reliable assessment.
Main Methods:
- Eighteen residents performed mastoidectomies on 3D-printed models and cadavers.
- Expert raters evaluated performances physically and via video recordings.
- Interrater and intrarater reliability were analyzed using kappa statistics and generalizability theory.
Main Results:
- Video-based and physical assessments showed comparable reliability (G coefficient 0.85 vs. 0.80 for models, 0.86 vs. 0.87 for cadavers).
- Moderate interrater reliability was observed (mean κ 0.58 for video, 0.60 for physical).
- Two raters evaluating two video performances or three raters physically assessing two performances ensured high-stakes reliability for models.
Conclusions:
- Video-based and physical assessments are equally reliable for surgical skills evaluation.
- Assessment modality should be consistent (either physical or video), not combined.
- Rater performance can be influenced by switching between assessment methods.
