Ann R Coll Surg Engl 2008; 90: 286-290 286The ability to assess one's own performance critically in surgery is a valuable trait for surgeons throughout training and independent practice. Unfortunately, this remains an underdeveloped skill in surgical training and receives little attention from surgical educators. For trainees, it allows identification of their strengths and, more importantly, weaknesses in their ability, to build upon previous performance and take the necessary remedial action. For surgeons in independent practice, the introduction of new surgical techniques necessitates focused self-assessment.Evidence for self-assessment in surgery is poor, compared self, peer and supervisor ratings with scores on the American Board of Surgery InTraining Examination (ABSITE). The results showed significant correlation between ratings by peers and supervisors (r = 0.92; P < 0.001). The average of peer and supervisor ratings showed a moderate correlation with ABSITE scores (r = 0.58; P < 0.01). Multivariate analysis suggested that supervisors were influenced mainly by the interpersonal skill of the resident and secondarily by their ability. Self-assessment was influenced mainly by the residents' perceptions of their own ability, followed by interpersonal skills and effort.

Objective improvements in technical performance follow intensive workshop training. Participants' perform better, faster, and with an improved end product following the course. Such adjuncts to training play an important part in a focused integrated programme that addresses reduced work hours.

Senior trainees achieved the same score as consultants, suggesting a similar level of basic technical skill and knowledge required to perform CEA, and were significantly better than junior trainees. Performance on the bench model could provide an early assessment for suitability to proceed to operative training in a competency-based training and assessment programme.