Clarke Michelle J, Lund Sarah, White Bobbie Ann Adair, Gerberi Danielle, Edwards Roger A
Department of Neurologic Surgery, Mayo Clinic, Rochester, MN.
Department of Surgery, Mayo Clinic, Rochester, MN.
J Surg Educ. 2025 Aug;82(8):103546. doi: 10.1016/j.jsurg.2025.103546. Epub 2025 May 24.
Real-world assessment of trainee surgical competence and autonomy must occur in the operative environment. It is unclear if or how workplace-based operative skills assessments are systematically incorporated into summative evaluations. In this study, intraoperative surgical skills assessment tools were reviewed for actual or proposed incorporation into summative evaluations.
A scoping review was conducted. The Cochrane Central Registrar of Clinical Trials, Embase, Medline, and Web of Science were searched for articles published from January 2012 to December 2021. Articles describing an educational assessment paradigm of a post-graduate surgical trainee performing an open surgical procedure were selected. Using the PRISMA Extension Guidelines for Scoping Reviews, two independent reviewers completed data extraction including literature quality, assessment paradigm, assessment quality, incorporation into summative evaluations, and facilitators and barriers to implementation. Finally, a narrative synthesis of extracted data was completed.
Twenty-two articles met inclusion criteria describing 11 different surgical assessments. All were cohort studies, of which 21 involved the evaluation of an assessment tool and one involved participant perceptions of the assessment tool. All studies discussed the possible use of their assessment to track progress over time, but no study explicitly outlined the incorporation of the tool into a summative review. Four types of assessments automatically integrated results, which reportedly were utilized at Clinical Competency Committee (CCC) meetings. Facilitators and barriers of surgical assessment integration into summative assessments was not described.
While proponents of formative intra-operative assessment have claimed that their potential use in supporting summative evaluation and tracking learning trajectories are major benefits, a systematic method of integrating workplace surgical assessments into summative resident evaluation has not been described or uniformly implemented.
对外科实习生手术能力和自主性的实际评估必须在手术环境中进行。目前尚不清楚基于工作场所的手术技能评估是否以及如何系统地纳入总结性评估。在本研究中，对术中手术技能评估工具进行了审查，以确定其是否实际或拟纳入总结性评估。
进行了一项范围综述。检索了考克兰临床试验中央注册库、Embase、Medline和科学网，以查找2012年1月至2021年12月发表的文章。选择描述研究生外科实习生进行开放手术的教育评估范式的文章。两名独立评审员根据范围综述的PRISMA扩展指南完成了数据提取，包括文献质量、评估范式、评估质量、纳入总结性评估以及实施的促进因素和障碍。最后，对提取的数据进行了叙述性综合。
22篇文章符合纳入标准，描述了11种不同的手术评估。所有文章均为队列研究，其中21篇涉及评估工具的评估，1篇涉及参与者对评估工具的看法。所有研究都讨论了使用其评估来跟踪随时间推移的进展的可能性，但没有研究明确概述将该工具纳入总结性审查的情况。四种类型的评估自动整合了结果，据报道这些结果在临床能力委员会（CCC）会议上得到了利用。未描述将手术评估整合到总结性评估中的促进因素和障碍。
虽然形成性术中评估的支持者声称，其在支持总结性评估和跟踪学习轨迹方面的潜在用途是主要益处，但尚未描述或统一实施将工作场所手术评估整合到住院医师总结性评估中的系统方法。
