Establishing the predictive validity of the intercollegiate membership of the Royal Colleges of surgeons written examination: MRCS part B

Ellis, Ricky; Cleland, Jennifer; Scrimgeour, Duncan; Lee, Amanda; Hines, John; Brennan, Peter A.

doi:10.1016/j.surge.2023.07.003

Cited by 1 publication

(1 citation statement)

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“…Tough achieving predictive validity often necessitates a more demanding endeavor, and there is still a significant opportunity to develop study settings correlating tool scores with clinical outcomes 91,92 . The General Medical Council (GMC) in the UK has even stated that in the absence of the gold standard, exploring the strength of the relationship between similar established assessment tools, from different surgical specialities, might offer itself as an alternative 93 . Furthermore, more granular analysis of surgical skills, such as the objective clinical human reliability analysis (OCHRA) could enhance the likelihood of achieving predictive validity, associating technical kills with clinical outcomes, regardless of level of expertise 94 …”

Section: Discussionmentioning

confidence: 99%

Objective assessment tools in laparoscopic or robotic‐assisted gynecological surgery: A systematic review

Tesfai,

Nagi,

Morrison

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionThere is a growing emphasis on proficiency‐based progression within surgical training. To enable this, clearly defined metrics for those newly acquired surgical skills are needed. These can be formulated in objective assessment tools. The aim of the present study was to systematically review the literature reporting on available tools for objective assessment of minimally invasive gynecological surgery (simulated) performance and evaluate their reliability and validity.Material and methodsA systematic search (1989–2022) was conducted in MEDLINE, Embase, PubMed, Web of Science in accordance with PRISMA. The trial was registered with the Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022376552. Randomized controlled trials, prospective comparative studies, prospective single‐group (with pre‐ and post‐training assessment) or consensus studies that reported on the development, validation or usage of assessment tools of surgical performance in minimally invasive gynecological surgery, were included. Three independent assessors assessed study setting and validity evidence according to a contemporary framework of validity, which was adapted from Messick's validity framework. Methodological quality of included studies was assessed using the modified medical education research study quality instrument (MERSQI) checklist. Heterogeneity in data reporting on types of tools, data collection, study design, definition of expertise (novice vs. experts) and statistical values prevented a meaningful meta‐analysis.ResultsA total of 19 746 titles and abstracts were screened of which 72 articles met the inclusion criteria. A total of 37 different assessment tools were identified of which 13 represented manual global assessment tools, 13 manual procedure‐specific assessment tools and 11 automated performance metrices. Only two tools showed substantive evidence of validity. Reliability and validity per tool were provided. No assessment tools showed direct correlation between tool scores and patient related outcomes.ConclusionsExisting objective assessment tools lack evidence on predicting patient outcomes and suffer from limitations in transferability outside of the research environment, particularly for automated performance metrics. Future research should prioritize filling these gaps while integrating advanced technologies like kinematic data and AI for robust, objective surgical skill assessment within gynecological advanced surgical training programs.

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Section: Discussionmentioning

confidence: 99%