Kim Alexandrea H, Vaughn Cory A, King Deanne L, Maizels Max, Meade Patrick, Stack Brendan C
College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Head Neck. 2020 Dec;42(12):3551-3557. doi: 10.1002/hed.26420. Epub 2020 Aug 19.
Self-awareness of skill, essential for progression as a surgeon, has direct bearing on postresidency practice; however, studies have supported that residents achieve self-perceived competence later than believed by program directors. This study compares residents' self-perception of operative competency to attending surgeon's evaluation using Computer Enhanced Visual Learning, a validated online hemithyroidectomy-specific assessment tool.
Eleven otolaryngology-Head and Neck Surgery (HNS) residents completed a preoperative module and postoperative survey, later reviewed by an attending surgeon. Eighty-three performances were assessed for inter-rater reliabilities of key surgical steps.
Almost perfect agreement (Kappa = 0.81-1.00) was shown in 11 of 18 parameters. Substantial agreement (Kappa = 0.61-0.80) was demonstrated in the remaining seven parameters.
Otolaryngology-HNS trainees have high self-awareness of their performance at each step in a hemithyroidectomy. Standardized assessment tools can allow for documentation of procedural performance and serve as guides for improvement. This is the only study to examine otolaryngology-HNS trainees' self-perceived skill compared to an attending surgeon's assessment for hemithyroidectomy.
技能的自我认知是外科医生职业发展的关键，对住院医师培训后的实践有直接影响；然而，研究表明住院医师获得自我认知的能力比项目主任认为的要晚。本研究使用经过验证的在线半甲状腺切除术特定评估工具——计算机增强视觉学习，比较住院医师对手术能力的自我认知与主治外科医生的评估。
11名耳鼻咽喉头颈外科（HNS）住院医师完成了术前模块和术后调查，随后由主治外科医生进行审查。对83次手术表现评估关键手术步骤的评分者间信度。
18项参数中的11项显示出几乎完全一致（kappa = 0.81 - 1.00）。其余7项参数显示出实质性一致（kappa = 0.61 - 0.80）。
耳鼻咽喉头颈外科实习生对半甲状腺切除术各步骤的表现有较高的自我认知。标准化评估工具可以记录手术操作表现，并作为改进的指导。这是唯一一项比较耳鼻咽喉头颈外科实习生与主治外科医生对半甲状腺切除术自我认知技能的研究。
