Presented in part to a meeting of the Society for Vascular Surgery, Philadelphia, Pennsylvania, USA, July 2006, and to a meeting of the Vascular Society of Great Britain and Ireland, Bournemouth, UK, November 2005, and published in abstract form as Br J Surg 2006; 93(Suppl 2): 37
Assessment of surgical competence at carotid endarterectomy under local anaesthesia in a simulated operating theatre†
Article first published online: 23 FEB 2010
Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 97, Issue 4, pages 511–516, April 2010
How to Cite
Black, S. A., Nestel, D. F., Kneebone, R. L. and Wolfe, J. H. N. (2010), Assessment of surgical competence at carotid endarterectomy under local anaesthesia in a simulated operating theatre. Br J Surg, 97: 511–516. doi: 10.1002/bjs.6938
- Issue published online: 4 MAR 2010
- Article first published online: 23 FEB 2010
- Manuscript Accepted: 4 NOV 2009
Methods of surgical training that do not put patients at risk are desirable. A high-fidelity simulation of carotid endarterectomy under local anaesthesia was tested as a tool for assessment of vascular surgical competence, as an adjunct to training.
Sixty procedures were performed by 30 vascular surgeons (ten junior trainees, ten senior trainees and ten consultants) in a simulated operating theatre. Each performed in a non-crisis scenario followed by a crisis scenario. Performance was assessed live by means of rating scales for technical and non-technical skills.
There was a significant difference in technical skills with ascending grade for both generic and procedure-specific technical skill scores in both scenarios (P < 0·001 for all comparisons). Similarly, there was also a significant difference in non-technical skill with ascending grade for both scenarios (P < 0·001). There was a highly significant correlation between technical and non-technical performance in both scenarios (non-crisis: rs = 0·80, P < 0·001; crisis: rs = 0·85, P < 0·001). Inter-rater reliability was high (α≥ 0·80 for all scales).
High-fidelity simulation offers competency-based assessment for all grades and may provide a useful training environment for junior trainees and more experienced surgeons. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.