Objective assessment of technical skills in cardiac surgery

Hance, Julian; Aggarwal, Rajesh; Stanbridge, Rex; Blauth, Christopher; Munz, Yaron; Darzi, Ara; Pepper, John

doi:10.1016/j.ejcts.2005.03.012

Cited by 66 publications

(62 citation statements)

References 15 publications

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“…Thus, the absence of expertnovice differences would substantially undermine the validity argument, but confirming the presence of such differences contributes only minimal incremental support (Cook 2014). Among these expert-novice differences, there appears to be an interaction with task complexity, with the rating scales better able to discriminate novices from experts on more complex tasks compared with less complex tasks Hance et al 2005;Leong et al 2008;Willems et al 2009;Black et al 2010;Kassab et al 2011). This topic requires further study, particularly examining if the global rating scale or checklist is more sensitive to this issue of task complexity.…”

Section: Relationships With Training Levelsmentioning

confidence: 78%

“…In one study, inter-rater reliability, inter-station reliability and expert-novice discrimination were higher with live versus video-based scoring in a two station OSATS for vascular surgery, although reliability was acceptable for both formats (Pandey et al 2004). In a second study, correlation of global ratings scores between live and video review formats was high, and interrater reliability and expert-novice discrimination were near perfect in both formats (Hance et al 2005). …”

Section: Video Versus Live Ratingsmentioning

confidence: 95%

“…Since it's original description, numerous investigators have made minor adaptations to the global rating scale, generally related to specific aspects of the technical skill assessed or the conditions of observation. The modifications include: removing the items ''knowledge of instruments'' and ''use of assistants'' (Broe et al 2006) or replacing these terms with other task-relevant phrases (Friedlich et al 2001;Dath et al 2004;Hance et al 2005); adding an overall performance rating (Dath et al 2004;Datta et al 2006;Hance et al 2005;Hislop et al 2006;Leong et al 2008;Willems et al 2009); or adding an overall product quality rating (Hance et al 2005;Datta et al 2006;Hislop et al 2006;Leong et al 2008). Each of these modifications aligned with the original intent of the global rating scale, and in each case the instrument retained the majority of items from the original.…”

Section: Osats Descriptionmentioning

confidence: 97%

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Constructing a validity argument for the Objective Structured Assessment of Technical Skills (OSATS): a systematic review of validity evidence

Hatala

Cook

Brydges

et al. 2015

Adv in Health Sci Educ

126

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In order to construct and evaluate the validity argument for the Objective Structured Assessment of Technical Skills (OSATS), based on Kane's framework, we conducted a systematic review. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus, and selected reference lists through February 2013. Working in duplicate, we selected original research articles in any language evaluating the OSATS as an assessment tool for any health professional. We iteratively and collaboratively extracted validity evidence from included articles to construct and evaluate the validity argument for varied uses of the OSATS. Twenty-nine articles met the inclusion criteria, all focussed on surgical technical skills assessment. We identified three intended uses for the OSATS, namely formative feedback, high-stakes assessment and program evaluation. Following Kane's framework, four inferences in the validity argument were examined (scoring, generalization, extrapolation, decision). For formative feedback and high-stakes assessment, there was reasonable evidence for scoring and extrapolation. However, for high-stakes assessment there was a dearth of evidence for generalization aside from inter-rater reliability data and an absence of evidence linking multi-station OSATS scores to performance in real clinical settings. For program evaluation, the OSATS validity argument was supported by reasonable generalization and extrapolation evidence. There was a complete lack of evidence regarding implications and decisions based on OSATS scores. In general, validity evidence supported the use of the OSATS for formative feedback. Research to provide support for decisions based on OSATS scores is required if the OSATS is to be used for higher-stakes decisions and program evaluation.

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Section: Relationships With Training Levelsmentioning

confidence: 78%

Section: Video Versus Live Ratingsmentioning

confidence: 95%

Section: Osats Descriptionmentioning

confidence: 97%

See 1 more Smart Citation

Constructing a validity argument for the Objective Structured Assessment of Technical Skills (OSATS): a systematic review of validity evidence

Hatala

Cook

Brydges

et al. 2015

Adv in Health Sci Educ

126

View full text Add to dashboard Cite

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“…57 In another, bench-top simulations accurately correlated with seniority and experience amongst cardiothoracic surgical trainees and consultants. 58 What still remains to be determined is the level at which acceptable skills have been attained to allow advancement and clinical practice without oversight. How such work might be reflected in the standards created during the Challenge will be difficult to determine, but given that this is a likely direction for the future of credentialing, such a discussion is warranted.…”

Section: Surgical Training and Continuing Medical Educationmentioning

confidence: 99%

“…It may be useful, however, for estimating the amount of surgical services that might be anticipated for the global population. 58,617 Other intestinal infections 69,534 Other infectious diseases 41 6. Alzheimer and other dementias*…”

Section: Appendix I: Disability-adjusted Life Years Due To Conditionsmentioning

confidence: 99%

Patterns in neurosurgical adverse events: open cerebrovascular neurosurgery

Wong¹,

Ziewacz

et al. 2012

FOC

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Object As part of a project to devise evidence-based safety interventions for specialty surgery, we sought to review current evidence concerning the frequency of adverse events in open cerebrovascular neurosurgery and the state of knowledge regarding methods for their reduction. This review represents part of a series of papers written to consolidate information about these events and preventive measures as part of an ongoing effort to ascertain the utility of devising system-wide policies and safety tools to improve neurosurgical practice. Methods The authors performed a PubMed search using search terms “cerebral aneurysm”, “cerebral arteriovenous malformation”, “intracerebral hemorrhage”, “intracranial hemorrhage”, “subarachnoid hemorrhage”, and “complications” or “adverse events.” Only papers that specifically discussed the relevant complication rates were included. Papers were chosen to be included to maximize the range of rates of occurrence for the reported adverse events. Results The review revealed hemorrhage-related hyperglycemia (incidence rates ranging from 27% to 71%) and cerebral salt-wasting syndromes (34%–57%) to be the most common perioperative adverse events related to subarachnoid hemorrhage (SAH). Next in terms of frequency was new cerebral infarction associated with SAH, with a rate estimated at 40%. Many techniques are advocated for use during surgery to minimize risk of this development, including intraoperative neurophysiological monitoring, but are not universally used due to surgeon preference and variable availability of appropriate staffing and equipment. The comparative effectiveness of using or omitting monitoring technologies has not been evaluated. The incidence of perioperative seizure related to vascular neurosurgery is unknown, but reported seizure rates from observational studies range from 4% to 42%. There are no standard guidelines for the use of seizure prophylaxis in these patients, and there remains a need for prospective studies to support such guidelines. Intraoperative rupture occurs at a rate of 7% to 35% and depends on aneurysm location and morphology, history of rupture, surgical technique, and surgeon experience. Preventive strategies include temporary vascular clipping. Technical adverse events directly involving application of the aneurysm clip include incomplete aneurysm obliteration and parent vessel occlusion. The rates of these events range from 5% to 18% for incomplete obliteration and 3% to 12% for major vessel occlusion. Intraoperative angiography is widely used to confirm clip placement; adjuncts include indocyanine green video angiography and microvascular Doppler ultrasonography. Use of these technologies varies by institution. Discussion A significant proportion of these complications may be avoidable through development and testing of standardized protocols to incorporate monitoring technologies and specific technical practices, teamwork and communication, and concentrated volume and specialization. Collaborative monitoring and evaluation of such protocols are likely necessary for the advancement of open cerebrovascular neurosurgical quality.

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Cadaveric Simulation Training in Cardiothoracic Surgery: A Systematic Review

Robinson

Piekut

Hasman

et al. 2019

Anatomical Sciences Ed

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Simulation training has become increasingly relevant in the educational curriculum of surgical trainees. The types of simulation models used, goals of simulation training, and an objective assessment of its utility and effectiveness are highly variable. The role and effectiveness of cadaveric simulation in cardiothoracic surgical training has not been well established. The objective of this study was to evaluate the current medical literature available on the utility and the effectiveness of cadaveric simulation in cardiothoracic surgical residency training. A literature search was performed using PubMed, Cochrane Library, Embase, Scopus, and CINAHL from inception to February 2019. Of the 362 citations obtained, 23 articles were identified and retrieved for full review, yielding ten eligible articles that were included for analysis. One additional study was identified and included in the analysis. Extraction of data from the selected articles was performed using predetermined data fields, including study design, study participants, simulation task, performance metrics, and costs. Most of these studies were only descriptive of a cadaveric or perfused cadaveric simulation model that could be used to augment clinical operative training in cardiothoracic surgery. There is a paucity of evidence in the literature that specifically evaluates the utility and the efficacy of cadavers in cardiothoracic surgery training. Of the few studies that have been published in the literature, cadaveric simulation does seem to have a role in cardiothoracic surgery training beyond simply learning basic skills. Additional research in this area is needed. Anat Sci Educ 13: 406-418.

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Objective assessment of technical skills in cardiac surgery

Cited by 66 publications

References 15 publications

Constructing a validity argument for the Objective Structured Assessment of Technical Skills (OSATS): a systematic review of validity evidence

Constructing a validity argument for the Objective Structured Assessment of Technical Skills (OSATS): a systematic review of validity evidence

Patterns in neurosurgical adverse events: open cerebrovascular neurosurgery

Cadaveric Simulation Training in Cardiothoracic Surgery: A Systematic Review

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