High-stakes Technical Performance Assessments Across the Continuum of Surgical Training

Area of Science:

• Surgical Education
• Medical Assessment
• Performance Science

Background:

• Advancements in technology enable operative technical skill assessment outside the traditional workplace.
• Competency-based education in surgery necessitates valid and reliable assessments for high-stakes decisions.
• The role of non-workplace performance assessments in surgical training requires further definition.

Purpose of the Study:

• To propose the implementation of high-stakes technical performance assessments throughout surgical training.
• To define these assessments as evaluations of technical skill conducted outside the operating theatre.

Main Methods:

• Review of surgical skill acquisition and assessment theories.
• Analysis of contemporary evidence from performance science literature.
• Discussion of high-stakes performance assessments across the surgical training continuum.

Main Results:

• Surgical training requires assessments with progressively increasing professional authenticity.
• Early training assessments should focus on core skills and common procedures with low authenticity.
• Later training assessments rely more on workplace-based evaluations, supplemented by simulation for less frequent procedures.

Conclusions:

• High-stakes performance assessments are integral to programmatic surgical training and certification.
• Appropriate design and professional authenticity are crucial for effective assessment of surgical constructs.