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Data-Driven Metrics of Operative Performance: The Technology-Enhanced Surgical Training (TEST) Delphi Consensus Study
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
Summary
This study established consensus on key metrics for surgical training assessment. These advanced metrics will improve feedback and enhance trainee development and patient safety.
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.
