Assessment of improvement of trainee surgical skills in the operating room for tonsillectomy.

OBJECTIVES/HYPOTHESIS: To determine the feasibility, reliability, and validity of an objective surgical assessment tool designed to measure the development of tonsillectomy skills by resident trainees in the operating room. A tonsillectomy evaluation instrument created previously serves as a basis for this tool, which incorporates many similar concepts but was optimized to maximize feasibility and reliability with simplified anchors and inclusion of global and task-specific sections.

STUDY DESIGN

Prospective longitudinal validation study.

METHODS

Faculty input via modified Delphi technique was used to develop a new objective structured assessment of technical skills-based instrument for tonsillectomy. The task-specific checklist (TSC) and global rating scale (GRS) measured tonsillectomy technical skills and overall surgical performance, respectively. Twenty-one otolaryngology-head and neck residents (ranging from postgraduate year 1 to 6) were evaluated for a period of 3 years by 11 faculty members.

RESULTS

Eighty-three evaluations were completed showing strong correlation between both instruments (r = 0.95, P < .001). Our tool demonstrated construct validity for both TSC and GRS, showing higher scores with increasing surgical experience. Both instruments showed high interitem reliability with Cronbach α coefficients of 0.97 for both parts.

CONCLUSIONS

This assessment tool is a feasible, reliable, and valid instrument for the assessment of surgical competency in tonsillectomy. It is effective in providing structured feedback at the end of each procedure, which encourages specific, targeted development.