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

Authors

  • Aadil Ahmed MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
    Search for more papers by this author
    • Aadil Ahmed, MD, and Stacey L. Ishman, MD, MPH, are co-first authors.

  • Stacey L. Ishman MD, MPH,

    1. Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
    Search for more papers by this author
    • Aadil Ahmed, MD, and Stacey L. Ishman, MD, MPH, are co-first authors.

  • Kulsoom Laeeq MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
    Search for more papers by this author
  • Nasir I. Bhatti MD, MHS

    Corresponding author
    • Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
    Search for more papers by this author

  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Send correspondence to Nasir I. Bhatti, MD, 601 N. Caroline St. Suite 6241, Johns Hopkins Outpatient Centre, Baltimore, MD 21287. E-mail: nbahatti@jhmi.edu

Abstract

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. Laryngoscope, 2013

Ancillary