Roach Paul B, Roggin Kevin K, Selkov Eugene, Posner Mitchell C, Silverstein Jonathan C
Computation Institute, RI 405, University of Chicago, Chicago, IL 60637, USA.
Ann Surg Oncol. 2009 May;16(5):1100-7. doi: 10.1245/s10434-008-0186-6. Epub 2009 Feb 12.
Systems for assessing surgical trainee competence must be practical, reliable, and valid. We developed a novel system, the Surgical Training and Assessment Tool (STAT), for longitudinal competency assessments of surgical trainees' operative performances. We hypothesized the tool would be both practical and reliable within an academic surgical oncology training program.
Three surgical qualities of our primary interest (knowledge, skill, and independence) and the key technical maneuvers of approximately 200 surgical oncology procedures were defined and organized into hierarchical menus and loaded into a secure, web-based database. After every training case, trainee and attending surgeon electronically submitted evaluations of the trainee's performance, along with comments, and an overall grade. Data on system use and scores were analyzed.
Over the first 14 months of use at a university-based surgical oncology fellowship program, 1,029 assessments were recorded (528 attending surgeon, 501 trainee self-assessments). Median time to complete each assessment was 39 s (range 9-532 s, mean 60 s). Knowledge, skill, and independence assessments each demonstrated strong correlation with overall competency grade (Pearson correlations 0.60, 0.76, and 0.69, respectively). Multiple linear regression analysis showed all to be significant predictors of the overall grade (model R (2) = 0.63; test of predictive significance p < 0.001 for each).
STAT is a novel system for tracking and assessing trainee operative performance, which is easily integrated into the workflow of an academic surgical oncology department. Our analysis suggests that it is a practical and reliable instrument; its validity is promising and warrants further study.
评估外科实习医生能力的系统必须实用、可靠且有效。我们开发了一种新颖的系统——外科培训与评估工具（STAT），用于对外科实习医生的手术操作表现进行纵向能力评估。我们假设该工具在学术性外科肿瘤学培训项目中既实用又可靠。
确定了我们主要关注的三种手术素质（知识、技能和独立性）以及约200种外科肿瘤学手术的关键技术操作，并将其组织成层次化菜单，加载到一个安全的基于网络的数据库中。在每例培训病例后，实习医生和指导外科医生通过电子方式提交对实习医生表现的评估、评论及总体评分。对系统使用情况和分数数据进行了分析。
在一个大学附属外科肿瘤学 fellowship 项目使用该系统的前14个月里，记录了1029次评估（528次指导外科医生评估，501次实习医生自我评估）。完成每次评估的中位时间为39秒（范围9 - 532秒，平均60秒）。知识、技能和独立性评估与总体能力评分均显示出强相关性（皮尔逊相关系数分别为0.60、0.76和0.69）。多元线性回归分析表明，所有这些都是总体评分的显著预测因素（模型R² = 0.63；每个预测因素的预测显著性检验p < 0.001）。
STAT是一种用于跟踪和评估实习医生手术表现的新颖系统，可轻松整合到学术性外科肿瘤学部门的工作流程中。我们的分析表明它是一种实用且可靠的工具；其有效性前景良好，值得进一步研究。
