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Related Experiment Video

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How Many Operative Performance Ratings Does a Pediatric Surgery Fellow Need to Be Deemed Practice Ready?

Brianna L Spencer1, Andrew Krumm2, Shawn Izadi3

  • 1Section of Pediatric Surgery, Department of Surgery, University of Michigan Medical School, C.S. Mott Children's Hospital, 1540 E Hospital Dr, Ann Arbor, MI, 48109, USA.

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|October 16, 2023
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Summary
This summary is machine-generated.

Determining surgical fellow competence is challenging. This study shows workplace-based assessment data can predict future performance, potentially establishing minimum case requirements for pediatric surgery fellows.

Keywords:
Operative performancePediatric surgerySIMPLWorkplace-based assessment

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Area of Science:

  • Medical Education
  • Surgical Training
  • Competency Assessment

Background:

  • Establishing objective criteria for surgical fellow competence is difficult.
  • Workplace-based assessment (WBA) systems offer practical data collection for performance evaluation.
  • WBA ratings can be translated into probabilistic predictions of future performance standards.

Purpose of the Study:

  • To assess the utility of WBA data in predicting pediatric surgery fellow competence.
  • To determine if WBA ratings can inform probabilistic statements about future performance.
  • To explore the establishment of minimum case number requirements for surgical training.

Main Methods:

  • Compared WBA data from two pediatric surgery training programs using the SIMPL performance rating scale.
  • Employed a Bayesian generalized linear mixed effects model to analyze past and future performance relationships.
  • Examined data for three specific procedures: Laparoscopic Inguinal Hernia Repair, Laparoscopic Gastrostomy Tube Placement, and Pyloromyotomy.

Main Results:

  • Across two sites, a significant number of assessments yielded practice-ready ratings (71% and 65%).
  • Model-based future performance expectations were similar across sites, with prior practice-ready ratings having a consistent effect (B=0.25).
  • Required prior practice-ready ratings varied by procedure, with Laparoscopic G-Tube Placement needing fewer (13-14) compared to Inguinal Hernia Repair and Pyloromyotomy (10-15).

Conclusions:

  • The developed approach effectively models operative performance data to predict future practice readiness in pediatric surgery fellows.
  • This modeling method demonstrates potential for establishing minimum case number requirements in surgical training.
  • The findings support the use of WBA data for objective competency assessment in surgical education.