Nonphysician Evaluators and Recording-Based Tools in Surgical Skill Assessment: A Feasibility Study

Area of Science:

• Orthopedic Surgery
• Surgical Education
• Medical Imaging

Background:

• Assessing surgical skill is crucial for patient safety and effective training.
• Traditional assessment methods can be subjective and time-consuming.
• Objective, reproducible tools are needed for surgical skill evaluation.

Purpose of the Study:

• To evaluate the feasibility of using nonmedically trained personnel and image-based tools to assess surgical skills.
• To determine if video recordings and fluoroscopy images can differentiate skill levels in orthopedic trauma surgery.
• To assess the effectiveness of Global Rating Scales (GRS) and procedure-specific checklists.

Main Methods:

• Orthopedic surgeons of varying experience repaired cadaveric bi-malleolar ankle fractures.
• Video recordings and fluoroscopy images were independently scored by expert orthopedic surgeons and nonphysicians.
• Global Rating Scales (GRS) and procedure-specific checklists were used for evaluation.

Main Results:

• Expert surgeons differentiated skill levels using GRS for video/fluoroscopy and video checklists (p < 0.05).
• Nonphysician viewers generally identified skill differences, especially with checklists.
• Metrics like surgical time and experience also showed some skill differentiation.

Conclusions:

• Video and fluoroscopic imaging tools are feasible for assessing orthopedic surgical skills in trauma.
• These assessment methods are applicable in both cadaver labs and live surgical settings.
• Future studies should explore evaluator training needs and the role of surgical time in skill assessment.