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Primary hyperparathyroidism (PHPTH) affects women (34 to 268 per 100 000 patient-years) and men (13 to 85 per 100 000 patient-years), predominantly as asymptomatic hypercalcemia. 1 Patients are characterized by a multitude of nonspecific symptoms also found in other somatic or autoimmune conditions: general fatigue, polydipsia, polyuria, neuromuscular complaints, gastritis, and neuropsychiatric depression.

Background: Self-awareness of skill, essential for progression as a surgeon, has direct bearing on postresidency practice; however, studies have supported that residents achieve self-perceived competence later than believed by program directors. This study compares residents' self-perception of operative competency to attending surgeon's evaluation using Computer Enhanced Visual Learning, a validated online hemithyroidectomy-specific assessment tool. Methods: Eleven otolaryngology-Head and Neck Surgery (HNS) residents completed a preoperative module and postoperative survey, later reviewed by an attending surgeon. Eighty-three performances were assessed for inter-rater reliabilities of key surgical steps. Results: Almost perfect agreement (Kappa = 0.81-1.00) was shown in 11 of 18 parameters. Substantial agreement (Kappa = 0.61-0.80) was demonstrated in the remaining seven parameters. Conclusions: Otolaryngology-HNS trainees have high self-awareness of their performance at each step in a hemithyroidectomy. Standardized assessment tools can allow for documentation of procedural performance and serve as guides for improvement. This is the only study to examine otolaryngology-HNS trainees' self-perceived skill compared to an attending surgeon's assessment for hemithyroidectomy.