This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Assessment of operative competence during carotid endarterectomy. BJS 2007; 94: 726-730.
Published: 21st February 2007
Authors: J. D. Beard, S. Choksy, S. Khan
Background
Objective Structured Assessment of Technical Skills (OSATS) has been used to assess operative competence. The aim was to evaluate its role in carotid endarterectomy (CEA).
Method
Over 2 years, 17 trainees and 11 consultants were assessed by a single observer using a task‐specific checklist and global ratings. Operating time and previous experience were also recorded.
Results
Trainees had previously performed fewer CEAs than consultants (median (interquartile range, i.q.r.) 15 (7–24) versus 94 (61–133) respectively; P < 0·001) and they took longer to perform operations (median (i.q.r.) 128 (119–143) versus 90 (82·5–98·5) min; P < 0·001). Trainees achieved lower task‐specific (median (i.q.r.) 23 (17–26) versus 25 (24·5–27·5); P = 0·031) and global (33 (30–35) versus 40 (36·5–43); P = 0·001) scores than consultants. There was a strong positive correlation between task‐specific scores and experience for trainees (r = 0·83, P < 0·001), but not for consultants. Global ratings correlated with experience for trainees (r = 0·69, P = 0·002) and more so for consultants (r = 0·82, P = 0·002). There was a positive correlation between task‐specific and global scores for trainees (r = 0·67, P = 0·003), but not for consultants.
Conclusion
Task‐specific checklists were more discriminatory between trainees and may be useful for formative assessment (training). Global ratings were more discriminatory for consultants and may be useful for summative assessment (examination or revalidation). Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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