A novel approach to assessing technical competence of colorectal surgery residents: The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS)

Sandra L. De Montbrun; Patricia L. Roberts; Ann C. Lowry; Glenn T. Ault; Marcus J. Burnstein; Peter A. Cataldo; Eric J. Dozois; Gary D. Dunn; James Fleshman; Gerald A. Isenberg; Najjia N. Mahmoud; Richard K. Reznick; Lisa Satterthwaite; David Schoetz; Judith L. Trudel; Eric G. Weiss; Steven D. Wexner; Helen MacRae

doi:10.1097/SLA.0b013e31829b32b8

A novel approach to assessing technical competence of colorectal surgery residents: The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS)

Sandra L. De Montbrun, Patricia L. Roberts, Ann C. Lowry, Glenn T. Ault, Marcus J. Burnstein, Peter A. Cataldo, Eric J. Dozois, Gary D. Dunn, James Fleshman, Gerald A. Isenberg, Najjia N. Mahmoud, Richard K. Reznick, Lisa Satterthwaite, David Schoetz, Judith L. Trudel, Eric G. Weiss, Steven D. Wexner, Helen MacRae

Surgery

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Abstract

OBJECTIVE:: To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). BACKGROUND:: It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. METHODS:: A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at "borderline competent for CR practice." RESULTS:: The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27% of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. CONCLUSIONS:: The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.

Original language	English (US)
Pages (from-to)	1001-1006
Number of pages	6
Journal	Annals of Surgery
Volume	258
Issue number	6
DOIs	https://doi.org/10.1097/SLA.0b013e31829b32b8
State	Published - Dec 1 2013

Keywords

assessment
colorectal surgery
competency
education
technical skill

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De Montbrun, S. L., Roberts, P. L., Lowry, A. C., Ault, G. T., Burnstein, M. J., Cataldo, P. A., Dozois, E. J., Dunn, G. D., Fleshman, J., Isenberg, G. A., Mahmoud, N. N., Reznick, R. K., Satterthwaite, L., Schoetz, D., Trudel, J. L., Weiss, E. G., Wexner, S. D., & MacRae, H. (2013). A novel approach to assessing technical competence of colorectal surgery residents: The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS). Annals of Surgery, 258(6), 1001-1006. https://doi.org/10.1097/SLA.0b013e31829b32b8

A novel approach to assessing technical competence of colorectal surgery residents: The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS). / De Montbrun, Sandra L.; Roberts, Patricia L.; Lowry, Ann C. et al.
In: Annals of Surgery, Vol. 258, No. 6, 01.12.2013, p. 1001-1006.

Research output: Contribution to journal › Article › peer-review

De Montbrun, SL, Roberts, PL, Lowry, AC, Ault, GT, Burnstein, MJ, Cataldo, PA, Dozois, EJ, Dunn, GD, Fleshman, J, Isenberg, GA, Mahmoud, NN, Reznick, RK, Satterthwaite, L, Schoetz, D, Trudel, JL, Weiss, EG, Wexner, SD & MacRae, H 2013, 'A novel approach to assessing technical competence of colorectal surgery residents: The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS)', Annals of Surgery, vol. 258, no. 6, pp. 1001-1006. https://doi.org/10.1097/SLA.0b013e31829b32b8

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title = "A novel approach to assessing technical competence of colorectal surgery residents: The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS)",

abstract = "OBJECTIVE:: To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). BACKGROUND:: It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. METHODS:: A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at {"}borderline competent for CR practice.{"} RESULTS:: The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27% of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. CONCLUSIONS:: The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.",

keywords = "assessment, colorectal surgery, competency, education, technical skill",

author = "{De Montbrun}, {Sandra L.} and Roberts, {Patricia L.} and Lowry, {Ann C.} and Ault, {Glenn T.} and Burnstein, {Marcus J.} and Cataldo, {Peter A.} and Dozois, {Eric J.} and Dunn, {Gary D.} and James Fleshman and Isenberg, {Gerald A.} and Mahmoud, {Najjia N.} and Reznick, {Richard K.} and Lisa Satterthwaite and David Schoetz and Trudel, {Judith L.} and Weiss, {Eric G.} and Wexner, {Steven D.} and Helen MacRae",

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AU - Roberts, Patricia L.

AU - Lowry, Ann C.

AU - Ault, Glenn T.

AU - Burnstein, Marcus J.

AU - Cataldo, Peter A.

AU - Dozois, Eric J.

AU - Dunn, Gary D.

AU - Fleshman, James

AU - Isenberg, Gerald A.

AU - Mahmoud, Najjia N.

AU - Reznick, Richard K.

AU - Satterthwaite, Lisa

AU - Schoetz, David

AU - Trudel, Judith L.

AU - Weiss, Eric G.

AU - Wexner, Steven D.

AU - MacRae, Helen

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N2 - OBJECTIVE:: To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). BACKGROUND:: It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. METHODS:: A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at "borderline competent for CR practice." RESULTS:: The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27% of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. CONCLUSIONS:: The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.

AB - OBJECTIVE:: To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment of Technical Skill (COSATS). BACKGROUND:: It may be reasonable for the public to assume that surgeons certified as competent have had their technical skills assessed. However, technical skill, despite being the hallmark of a surgeon, is not directly assessed at the time of certification by surgical boards. METHODS:: A procedure-based, multistation technical skills examination was developed to reflect a sample of the range of skills necessary for CR surgical practice. These consisted of bench, virtual reality, and cadaveric models. Reliability and construct validity were evaluated by comparing 10 graduating CR residents with 10 graduating general surgery (GS) residents from across North America. Expert CR surgeons, blinded to level of training, evaluated performance using a task-specific checklist and a global rating scale. The mean global rating score was used as the overall examination score and a passing score was set at "borderline competent for CR practice." RESULTS:: The global rating scale demonstrated acceptable interstation reliability (0.69) for a homogeneous group of examinees. Both the overall checklist and global rating scores effectively discriminated between CR and GS residents (P < 0.01), with 27% of the variance attributed to level of training. Nine CR residents but only 3 GS residents were deemed competent. CONCLUSIONS:: The Colorectal Objective Structured Assessment of Technical Skill effectively discriminated between CR and GS residents. With further validation, the Colorectal Objective Structured Assessment of Technical Skill could be incorporated into the colorectal board examination where it would be the first attempt of a surgical specialty to formally assess technical skill at the time of certification.

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KW - colorectal surgery

KW - competency

KW - education

KW - technical skill

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A novel approach to assessing technical competence of colorectal surgery residents: The development and evaluation of the colorectal objective structured assessment of technical skill (COSATS)

Abstract

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UN SDGs

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