Defining milestones toward competency in mastoidectomy using a skills assessment paradigm

Abstract

The acquisition of mastoidectomy skills can be integrated into surgical teaching in the OR, and this approach yields information that can aid individual skill development and program improvement. The identification of milestones in particular can help establish training benchmarks toward achievement of competency and in identifying trainees in need of remediation.

Assessing Technical Competence in Surgical Trainees

“…125 In the reviewed literature and in other publications, most definitions have embedded within them a minimum standard needed to be safe and/or the ability to perform the operation independently without help. 31,35,45,48,51,53,55,56,[58][59][60][61][62]64,87,103,[105][106][107]109,110,[113][114][115] Surgical competence has been described as a collection of skill, knowledge, and judgment required to complete new or familiar tasks incorporating both technical and nontechnical (ie, clinical problem solving) components. [119][120][121] Furthermore, operative competence builds on this definition but also includes a surgeon's experience and opportunities to form a broader, more universal domain.…”

“…It is not to be confused with a taskspecific checklist found in the section "Binary outcome assessments." The task-specific scale in the included studies evaluated technical competence in Urology 44 and Otolaryngology, 45 and one of the studies evaluated surgery residents in the emergency department setting 46 (residents were from Orthopedics, Obstetrics, General Surgery, Otolaryngology, and Emergency Medicine, classified in this study as surgical on the basis of their hands-on exposures). The platforms utilized were live assessments performed intraoperatively or intraprocedurally via an open approach.…”

“…The platforms utilized were live assessments performed intraoperatively or intraprocedurally via an open approach. [44][45][46] ‡This study performed both a modified Angoff methodology as the primary standard setting approach and the contrasting groups and a Hofstee methodology for confirmation. CCV indicates concurrent validity; CGM, contrasting groups methodology; COV, content validity; CV, construct validity; EV, external validity; FV, face validity; IAR, intrarater reliability; IC, internal consistency; IRR, interrater reliability; PV, predictive validity; R Ø , reliability type not described; R C , reliability coefficient; R G , reliability via genaralizability analysis; ROC, receiver operating characteristic curve; R T , test-retest reliability; V Ø , validity type not described; VC, validity via cognitive task analysis.…”

“…31,35,45,48,51,53,55,56,[58][59][60][61][62]64,87,103,[105][106][107]109,110,[113][114][115] Differentiating competence from proficiency in the reviewed literature demonstrated that a proficient performer is one who approaches expertise and is thus at an advanced stage compared with a competent performer. 56,62,66,67,69,73,75,76,78-80,82-84,87-89,92-94, 96,97,100,113,116 …”

Determinants of resident competence in mastoidectomy: Role of interest and deliberate practice

“…4 Carr reported program directors' opinions regarding the number of key head and neck procedures required to deem a candidate competent. 18 The program directors were of the opinion that trainees achieve competency for mastoidectomy at the PGY-4 level after performing approximately 8 to 10 procedures, which is within the order of magnitude of experience associated with competency in cortical mastoidectomy within our training program.…”