Self-appraisal hierarchical task analysis of laparoscopic surgery performed by expert surgeons

Sarker, Sudip K.; Hutchinson, R.; Chang, Avril; Vincent, Charles; Darzi, Ara

doi:10.1007/s00464-005-0312-5

Cited by 40 publications

(34 citation statements)

References 13 publications

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“…Consequently, a total of 12 papers were included (Table 3). 7,8,11,12,[16][17][18][19][20][21][22][23] According to our criteria, eight studies (66.7%) found that self-assessment of technical skills is accurate (Table 4). 11,[16][17][18][19][20][21][22] All studies were evidence level 2b.…”

Section: Resultsmentioning

confidence: 92%

“…17 Increasing age and non-European nationality were found to increase self-assessment accuracy in one study (8.3%) 22 (level 3 recommendation). One study 18 A variety of technical skills were assessed. Four studies (33.3%) assessed multiple surgical skills.…”

Section: Participants Undertaking the Self-assessment Processmentioning

confidence: 99%

“…Two studies used two tools. 16,23 The following assessment tools were used in studies reporting that self-assessment is accurate: the operative component rating scale, 16 objective surgical skills assessment, 22 hierarchical task analysis, 18 standardised forms 19 and a self-assessment score of performance 20 (level 3 recommendation). Poor accuracy of selfassessment or divergent results were seen using the global rating scale, 7,12,16,17 objective structured assessment of technical skills, 11,21,23 a visual analogue scale 8 and a global score.…”

Section: Assessment Toolsmentioning

confidence: 99%

“…Poor accuracy of selfassessment or divergent results were seen using the global rating scale, 7,12,16,17 objective structured assessment of technical skills, 11,21,23 a visual analogue scale 8 and a global score. 18 One study indicated that unfamiliarity with selfassessment rating tools was a potential reason for poor selfassessment accuracy. 12 Self-assessors used retrospective video playback analysis in three studies (25.0%) 16,19,23 and its use was ambiguous in a further study (8.3%).…”

Section: Assessment Toolsmentioning

confidence: 99%

“…16 They found that the accuracy of self-assessment improved significantly Retrospective video playback analysis was used by the observers in six studies (50.0%). 7,11,[16][17][18]23 A further two studies (16.7%) used both video analysis and direct observation. 19,21 In four studies (33.3%), the observers used direct observation only.…”

Section: Assessment Toolsmentioning

confidence: 99%

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Are general surgeons able to accurately self-assess their level of technical skills?

Rizan

Ansell²,

Tilston

et al. 2015

annals

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Introduction Self-assessment is a way of improving technical capabilities without the need for trainer feedback. It can identify areas for improvement and promote professional medical development. The aim of this review was to identify whether selfassessment is an accurate form of technical skills appraisal in general surgery. Methods The PubMed, MEDLINE®, Embase™ and Cochrane databases were searched for studies assessing the reliability of self-assessment of technical skills in general surgery. For each study, we recorded the skills assessed and the evaluation methods used. Common endpoints between studies were compared to provide recommendations based on the levels of evidence. Results Twelve studies met the inclusion criteria from 22,292 initial papers. There was no level 1 evidence published. All papers compared the correlation between self-appraisal versus an expert score but differed in the technical skills assessment and the evaluation tools used. The accuracy of self-assessment improved with increasing experience (level 2 recommendation), age (level 3 recommendation) and the use of video playback (level 3 recommendation). Accuracy was reduced by stressful learning environments (level 2 recommendation), lack of familiarity with assessment tools (level 3 recommendation) and in advanced surgical procedures (level 3 recommendation). Conclusions Evidence exists to support the reliability of self-assessment of technical skills in general surgery. Several variables have been shown to affect the accuracy of self-assessment of technical skills. Future work should focus on evaluating the reliability of self-assessment during live operating procedures.

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Section: Resultsmentioning

confidence: 92%

Section: Participants Undertaking the Self-assessment Processmentioning

confidence: 99%

Section: Assessment Toolsmentioning

confidence: 99%

Section: Assessment Toolsmentioning

confidence: 99%

Section: Assessment Toolsmentioning

confidence: 99%

See 3 more Smart Citations

Are general surgeons able to accurately self-assess their level of technical skills?

Rizan

Ansell²,

Tilston

et al. 2015

annals

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Identifying and reducing risks in functional endoscopic sinus surgery through a hierarchical task analysis

Corbett

O’Connor

Byrne

et al. 2018

Laryngoscope Investig Oto

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Objective To develop a hierarchical task listing of steps required to perform successful Functional Endoscopic Sinus Surgery (FESS). To complete a technical and human factor analysis of tasks resulting in the identification of errors, frequency of occurrence, severity, and reduction through remediation. Methods A triangulation of methods was used in order to derive the steps required to complete a FESS: 1) a literature review was carried out of published descriptions of FESS techniques; 2) observations of three FESS; 3) interviews with surgeons on FESS techniques. Data sets were combined to develop a task analysis of a correct approach to conducting FESS. A review by 12 surgeons, and observation of 25 FESS resulted in refinement of the task analysis. With input from five consultant surgeons and one consultant anesthetist, a Systematic Human Error Reduction and Prediction Approach (SHERPA) was used to identify the risks and mitigating steps in FESS. Results Ten tasks and 49 subtasks required for a correct approach to completing FESS were identified based on literature review and expert consensus. A risk score for each subtask was calculated from a suitable risk matrix. Risk reduction methods at each subtask were detailed. High‐scoring subtasks were evaluated and varying strategies examined to reduce the likelihood and mitigate the impact of error. The study demonstrates the usefulness of the HTA and SHERPA approach in standardization and optimization of clinical practice in order to improve patient safety. Conclusion Hierarchical Task Analysis and SHERPA are valuable tools to deconstruct expert performance and to highlight potential errors in FESS. The HTA and SHERPA approach to surgical procedures are useful learning and assessment tools for novice surgeons. The information derived offers the opportunity to improve surgical training and enhance patient safety by identifying high‐risk steps in the procedure, and how risk can be mitigated. Level of Evidence 2c Outcomes Research

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Assessment and Accreditation in MAS

Champion¹,

Fingerhut

2015

Training in Minimal Access Surgery

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Self-appraisal hierarchical task analysis of laparoscopic surgery performed by expert surgeons

Abstract: Surgeons' self-evaluation is accurate for technical skills aspects of their operations. This study demonstrates that self-appraisal using HTA is feasible, accurate, and practical. The authors aim to increase the numbers in their study and also to recruit residents.

Cited by 40 publications

References 13 publications

Are general surgeons able to accurately self-assess their level of technical skills?

Are general surgeons able to accurately self-assess their level of technical skills?

Identifying and reducing risks in functional endoscopic sinus surgery through a hierarchical task analysis

Assessment and Accreditation in MAS

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