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Simulator Training for Endovascular Neurosurgery
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Data-Driven Metrics of Operative Performance: The Technology-Enhanced Surgical Training (TEST) Delphi Consensus

Lachlan Dick1, Victoria Ruth Tallentire2, Annemarie B Docherty3

  • 1Surgical Sabermetrics Laboratory, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom; Medical Education Directorate, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, United Kingdom.

Journal of Surgical Education
|September 19, 2025
PubMed
Summary
This summary is machine-generated.

This study established consensus on key metrics for surgical training assessment. These advanced metrics will improve feedback and enhance trainee development and patient safety.

Keywords:
artificial intelligencefeedbackoperative performancepatient careperformance metricssurgical trainingtechnology

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Area of Science:

  • Surgical Education and Training
  • Medical Simulation and Assessment
  • Healthcare Technology Integration

Background:

  • Traditional surgical assessment methods lack objectivity and reliability.
  • A need exists for consensus on critical metrics for technology-enhanced operative performance assessment.
  • Guidance is required on applying analytics to surgical training feedback.

Purpose of the Study:

  • To establish international consensus on advanced operative performance metrics for surgical training.
  • To identify optimal applications of these metrics for enhancing feedback in surgical education.

Main Methods:

  • A 3-round, data-driven Delphi method was employed.
  • An international panel of 57 surgical experts participated.
  • Metrics were rated on a 7-point Likert scale using an electronic survey (REDCap).

Main Results:

  • Twenty-two statements reached consensus, including 10 specific training metrics.
  • Key technical metrics: dissection plane, economy of motion, technical errors.
  • Key non-technical metrics: situation awareness, communication, decision-making, cognitive load.
  • Outcome metrics: safety score, adverse event reaction time, global performance score.
  • Applications: individual metric comparison, benchmarking, guiding formative assessments.

Conclusions:

  • International consensus was achieved on advanced operative performance metrics for surgical training.
  • These metrics provide a foundation for improved feedback and enhanced trainee development.
  • Next steps include validating existing and developing novel metrics for technology integration in surgical curricula.