Assessment of surgical competence for neck dissection: a pilot study.

BACKGROUND: Progressive implementation of the milestone competence-based curriculum has created a need for new objective and validated means to assess resident surgical proficiency. A previous systematic review of the literature by our group has highlighted a shortage of tools assessing surgical competence in oncologic procedures in otolaryngology - head and neck surgery. METHODS: We developed a procedure-specific assessment tool for neck dissection using a modified Delphi method. The 2-part design was modelled on the previously validated Objective Structured Assessment of Technical Skills checklist. The tool was then validated through a 1-year multicentric prospective study in collaboration with the residents and faculty from our academic centre. Additionally, we developed an online survey to assess the acceptability by residents and staff before and after the validation studies. RESULTS: A total of 29 evaluations were completed throughout the 2016-2017 academic year. Acceptability ranked high for both residents and staff, with a single discrepancy in responses regarding a potential formative as opposed to summative use of the tool. Validation study results showed significantly higher checklist scores among senior residents than junior residents, as well as a significant score progression over time (p < 0.05). Trends in scores on the task-specific tool correlated highly to results obtained on a validated global rating scale (p < 0.05). CONCLUSION: The first tool assessing surgical competence in oncologic otolaryngology - head and neck surgery has been developed and shows promising validity.

Development, translation, and preliminary validation of the neck dissection assessment tool.

BACKGROUND: The objective was to develop an assessment tool to evaluate residents' competency for neck dissection and provide preliminary evidence of feasibility, reliability, and validity. METHODS: Six surgeons developed a neck dissection assessment tool using a modified Delphi method and evaluated 58 neck dissections from six junior and six senior otolaryngology residents. RESULTS: The assessment tool uses a double checklist: a previously validated global rating scale (GRS) and a task-specific checklist (TSC). Use of the instrument appeared feasible and the average scores on the GRS and TSC differed significantly between junior and senior residents. The Pearson correlation coefficient between both checklists was 0.87. Intraclass correlation (ICC) for inter-rater reliability was 0.69 for the GRS, and 0.80 for the TSC. CONCLUSION: This study provides preliminary evidence of feasibility, reliability, and validity for the first neck dissection assessment tool and provides a foundation for further psychometric analysis and research.

Objective Assessment of Technical Skills in Otorhinolaryngology-Head and Neck Surgery Residents: A Systematic Review.

Objectives The primary goal is the indexation of validated methods used to assess surgical competency in otorhinolaryngology-head and neck surgery (ORL-HNS) residents. Secondary goals include assessment of the reliability and validity of these tools, as well as the documentation of specific procedures in ORL-HNS involved. Data Sources MEDBASE, OVID, Medline, CINAHL, and EBM, as well as the printed references, available through the Université de Montréal library. Review Methods The PRISMA method was used to review digital and printed databases. Publications were reviewed by 2 independent reviewers, and selected articles were fully analyzed to classify evaluation methods and categorize them by procedure and subspecialty of ORL-HNS involved. Reliability and validity were assessed and scored for each assessment tool. Results Through the review of 30 studies, 5 evaluation methods were described and validated to assess the surgical competency of ORL-HNS residents. The evaluation method most often described was the combined Global Rating Scale and Task-Specific Checklist tool. Reliability and validity for this tool were overall high; however, considerable data were unavailable. Eleven distinctive surgical procedures were studied, encompassing many subspecialties of ORL-HNS: facial plastics, general ear-nose-throat, laryngology, otology, pediatrics, and rhinology. Conclusions Although assessment tools have been developed for an array of surgical procedures, involving most ORL-HNS subspecialties, the use of combined checklists has been repeatedly validated in the literature and shown to be easily applicable in practice. It has been applied to many ORL-HNS procedures but not in oncologic surgery to date.