Assessment of surgical competency.

Technical skill is only one component of overall surgical competency, but it has been one of the most difficult to measure. Assessment methods are currently subjective and unreliable, and include techniques such as operative logs, end-of-rotation global assessments, and direct observation without criteria. Newer objective methods of technical skill assessment are being developed and undergoing rigorous validation, including methods such as direct observation with criteria, final product analysis, and hand-motion analysis. Following the example set in other fields in which high-stakes assessment is paramount, such as in aviation, virtual reality simulators have been introduced to surgical competency assessment and training. Significant work remains to integrate these assessments into both training programs and practice and to demonstrate a resultant improvement in surgical outcome.

A longitudinal study of emotional intelligence training for otolaryngology residents and faculty.

IMPORTANCE: Emotions underlie and influence physician communications and relationships with patients and colleagues. Training programs to enhance emotional attunement, or emotional intelligence (EI), for physicians and assess training effects are scarce. OBJECTIVE: To assess whether an EI training program for otolaryngology residents and faculty affects patient satisfaction. DESIGN, SETTING, AND PARTICIPANTS: Prospective longitudinal, cohort study of physician residents and faculty in an EI training program at the Department of Otolaryngology, University of Kansas Medical Center, with annual training from 2005 to 2011. INTERVENTIONS: Three levels of interventions included 4 years of repeated EI assessment, 7 years of highly interactive EI training with high-risk/high-stress simulations, and ongoing modeling and mentoring of EI skills by faculty. MAIN OUTCOMES AND MEASURES: Four levels of outcome of the EI training were assessed with the following questions: Did participants enjoy the program? Could they apply the training to their practice? Did it change their behavior? Did it affect patient satisfaction? The Emotional Quotient Inventory (EQ-i) was administered to faculty and residents, and the Press Ganey Patient Satisfaction Survey was completed by patients. RESULTS: Ninety-seven percent of participants (103 of 106) reported that they enjoyed the programs, and 98% (104 of 106) reported that they have or could have applied what they learned. Participants demonstrated improvement in mean EQ-i scores from 102.19 (baseline/pretraining) to 107.29 (posttraining and assessment 1 year later; change, 6.71; 95% CI, 3.44-9.98). This increase was sustained in successive years, and these results were supported with linear growth curve analysis. The total department mean EQ-i score in pretraining year 2005 was 104.29 ("average" range), with posttraining scores in the "high average" range (112.46 in 2006, 111.67 in 2007, and 113.15 in 2008). An increase in EQ-i scores and EI training corresponded with an increase in patient satisfaction scores. Percentile rank patient satisfaction scores before EI training ranged from 85% to 90%; after training, scores ranged from 92% to 99%. CONCLUSIONS AND RELEVANCE: Emotional intelligence training positively influences patient satisfaction and may enhance medical education and health care outcome.