From the Copenhagen Academy for Medical Education and Simulation (S.T., D.B.Z., A.F., J.B.C., L.K.), Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Hvidovre University Hospital (E.T.), Hvidovre, Denmark; and Department of Thoracic, Cardiac and Vascular Surgery, Odense University Hospital (A.F., J. B.), Odense, Denmark.
Simul Healthc. 2023 Oct 1;18(5):305-311. doi: 10.1097/SIH.0000000000000694. Epub 2022 Nov 2.
Surgical residents need structured and objective feedback to develop their skills and become capable of performing surgical procedures autonomously. A shortage of experienced surgical staff has prompted residents to seek feedback from self-assessment and peer assessments.
We investigated whether surgical residents can reliably rate their own and their peers' basic surgical skills using the Global Rating Scale (GRS) from the Objective Structured Assessment of Technical Skills.
The study was a prospective and descriptive study conducted using gap analysis at the Copenhagen Academy for Medical Education and Simulation (Copenhagen, Denmark) from 2016 to 2017. Surgical residents were recruited during a course in basic open surgical skills. Among 102 course participants, 53 met the inclusion criteria and 22 participated in the study.
We recruited surgical residents based in the Capital Region and Zealand Region of Demark, and 42% of eligible residents participated in the study. Surgical residents underestimated their own surgical performance (median, 17 [range, 15-18] vs. 20 [range, 19.75-22]; P < 0.001). They also rated their peers lower than an experienced rater did (median 10 [range, 8.75-14] vs. 15 and median 20.5 [range, 19-22] vs. 23; both P < 0.001). Gap analysis revealed residents had unrecognized strengths (ie, self-underappraisal) in most GRS domains.
Ratings are unreliable when surgical residents assess their own and their peers' performances using GRS. A gap analysis revealed unrecognized strengths in time and motion, instrument handling, knowledge of instruments and sutures, and knowledge of specific procedure as well as unrecognized weaknesses in flow of operation and forward planning.
外科住院医师需要有结构和客观的反馈来发展他们的技能，并能够独立进行手术操作。由于经验丰富的外科工作人员短缺，住院医师开始寻求自我评估和同伴评估的反馈。
我们研究了使用客观结构化手术技能评估的全球评定量表（GRS），外科住院医师是否可以可靠地对自己和同伴的基本手术技能进行评分。
这项前瞻性描述性研究于 2016 年至 2017 年在丹麦哥本哈根医学教育与模拟学院（哥本哈根）进行，采用差距分析。基本开放手术技能课程中招募了外科住院医师。在 102 名课程参与者中，有 53 名符合纳入标准，其中 22 名参与了研究。
我们招募了来自丹麦首都大区和西兰大区的外科住院医师，其中 42%的符合条件的住院医师参与了研究。外科住院医师低估了自己的手术表现（中位数 17 [范围 15-18] 与 20 [范围 19.75-22]；P<0.001）。他们对同伴的评分也低于经验丰富的评估者（中位数 10 [范围 8.75-14] 与 15 和中位数 20.5 [范围 19-22] 与 23；均 P<0.001）。差距分析显示，在大多数 GRS 领域，住院医师的表现存在未被认识到的优势（即自我低估）。
当外科住院医师使用 GRS 评估自己和同伴的表现时，评分是不可靠的。差距分析显示，在时间和动作、器械处理、器械和缝线知识以及特定手术知识方面存在未被认识到的优势，而在手术流程和前瞻性规划方面则存在未被认识到的劣势。
