A novel approach to assessing technical competence of colorectal surgery residents

The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS)

Sandra L. De Montbrun, Patricia L. Roberts, Ann C. Lowry, Glenn T. Ault, Marcus J. Burnstein, Peter A. Cataldo, Eric Dozois, Gary D. Dunn, James Fleshman, Gerald A. Isenberg, Najjia N. Mahmoud, Richard K. Reznick, Lisa Satterthwaite, David Schoetz, Judith L. Trudel, Eric G. Weiss, Steven D. Wexner, Helen MacRae

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

OBJECTIVE:: To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). BACKGROUND:: It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. METHODS:: A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at "borderline competent for CR practice." RESULTS:: The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27% of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. CONCLUSIONS:: The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.

Original languageEnglish (US)
Pages (from-to)1001-1006
Number of pages6
JournalAnnals of Surgery
Volume258
Issue number6
DOIs
StatePublished - Dec 1 2013

Fingerprint

Colorectal Surgery
Mental Competency
Certification
Checklist
Surgical Specialties
North America
Reproducibility of Results
Surgeons

Keywords

  • assessment
  • colorectal surgery
  • competency
  • education
  • technical skill

ASJC Scopus subject areas

  • Surgery

Cite this

A novel approach to assessing technical competence of colorectal surgery residents : The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS). / De Montbrun, Sandra L.; Roberts, Patricia L.; Lowry, Ann C.; Ault, Glenn T.; Burnstein, Marcus J.; Cataldo, Peter A.; Dozois, Eric; Dunn, Gary D.; Fleshman, James; Isenberg, Gerald A.; Mahmoud, Najjia N.; Reznick, Richard K.; Satterthwaite, Lisa; Schoetz, David; Trudel, Judith L.; Weiss, Eric G.; Wexner, Steven D.; MacRae, Helen.

In: Annals of Surgery, Vol. 258, No. 6, 01.12.2013, p. 1001-1006.

Research output: Contribution to journalArticle

De Montbrun, SL, Roberts, PL, Lowry, AC, Ault, GT, Burnstein, MJ, Cataldo, PA, Dozois, E, Dunn, GD, Fleshman, J, Isenberg, GA, Mahmoud, NN, Reznick, RK, Satterthwaite, L, Schoetz, D, Trudel, JL, Weiss, EG, Wexner, SD & MacRae, H 2013, 'A novel approach to assessing technical competence of colorectal surgery residents: The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS)', Annals of Surgery, vol. 258, no. 6, pp. 1001-1006. https://doi.org/10.1097/SLA.0b013e31829b32b8
De Montbrun, Sandra L. ; Roberts, Patricia L. ; Lowry, Ann C. ; Ault, Glenn T. ; Burnstein, Marcus J. ; Cataldo, Peter A. ; Dozois, Eric ; Dunn, Gary D. ; Fleshman, James ; Isenberg, Gerald A. ; Mahmoud, Najjia N. ; Reznick, Richard K. ; Satterthwaite, Lisa ; Schoetz, David ; Trudel, Judith L. ; Weiss, Eric G. ; Wexner, Steven D. ; MacRae, Helen. / A novel approach to assessing technical competence of colorectal surgery residents : The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS). In: Annals of Surgery. 2013 ; Vol. 258, No. 6. pp. 1001-1006.
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abstract = "OBJECTIVE:: To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). BACKGROUND:: It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. METHODS:: A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at {"}borderline competent for CR practice.{"} RESULTS:: The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27{\%} of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. CONCLUSIONS:: The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.",
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N2 - OBJECTIVE:: To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). BACKGROUND:: It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. METHODS:: A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at "borderline competent for CR practice." RESULTS:: The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27% of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. CONCLUSIONS:: The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.

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