Technical skills of endoscopic sinus surgery for performance assessment using the Delphi methodology

In surgical residency, competence has traditionally been defined by a specified number of surgical procedures. Modern advances in medical education and surgical fellowships have challenged this approach. It is widely accepted that a definition of a skill set, enabling a systematic, competency-based assessment is mandatory in surgical education.

We conducted an international Delphi study with panelists from the European Rhinologic Society, representing 27 countries. Through four rounds, the panel reached consensus on the phrasing of an assessment tool-, for the technical skills of endoscopic sinus surgery (ESS).

Thirty panelists participated throughout the study. The median age of the panelists was 54 years (range 31-66 years) with a median experience of 25 years (range 6-40 years). All were experts in the field of endoscopic sinus surgery. Consensus was reached. The final assessment tool consists of 21 items with descriptive anchors.

The assessment tool, European Endoscopic Sinus Surgery â€" Technical Skills Assessment (EE-TSA), enables a competency-based approach to acquiring and maintaining essential elements of endoscopic sinus surgery. The international Delphi panel makes the tool internationally applicable. Further research should gather validity evidence for EE-TSA, enhancing the assessment of ESS by setting a pass/fail-standard ultimately improving surgical outcomes and patient safety.