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PC116. Defining Trainee Skills Critical to the Competent Operative Performance of Vascular Surgical Procedures: Abstracts of the 2016 Vascular Annual MeetingThe Society for Vascular Surgery Vascular Annual Meeting

Research output: Contribution to journalMeeting abstractpeer-review

Erica L. Mitchell, Gregory L. Moneta, Nick Sevdalis, John F. Eidt

Original languageEnglish
Pages (from-to)187S-188S
JournalJournal of Vascular Surgery
Volume63
Issue number6, Supplement
Early online date23 May 2016
DOIs
E-pub ahead of print23 May 2016
PublishedJun 2016

King's Authors

Abstract

Objectives:
Traditionally, the assessment of surgical trainees in the operating room has been based on measures of technical ability, with limited evaluation of the ability to competently plan, prepare, perform, and manage varying aspects of a surgical procedure. This study sought to define the knowledge, skills/behaviors and attitudes (KSAs) that vascular surgery (VS) experts expect in VS trainees when evaluating their operative competence. This information is vital to the development of an operative performance rating system applicable to all procedures for all VS trainees.

Methods:
Semistructured interviews were conducted with masters in the field of vascular surgery to elicit the key components of vascular surgical competency. Interview questions were designed to gain an understanding of the framework used by experts to assess VS trainee operative competency. All interviews were conducted by a single interviewer. Interviews were coded using emergent theme analysis by 2 independent reviewers. Data were extracted. Reliability and validity of theme identification were assessed by comparing each researcher's coding and categorization decisions.

Results:
Twenty nationally respected and experienced VSs were interviewed for the study. Fifteen themes, assigned to three categories, dominated the interviews (Table). Overall, leaders stressed the need to evaluate nontechnical skill ability over technical ability and knowledge. The top five cited determinants of operative competence included procedural rationale (100%), situational awareness (95%), coping ability (90%), vascular exposure (90%), and operative planning (80%). Lesser-cited determinants included leadership (75%), communication (70%), knowledge of procedural anatomy (70%), knowledge of procedural steps (70%), and endovascular skills (65%). Least-cited domains included knowledge of strategies to manage unexpected events (60%), knowledge of essential patient data (60%), teamwork (60%), assessment of operative outcomes (60%), and core surgical skills (55%).

Conclusions:
This is the first prospective study to systematically identify what expert vascular surgeons consider important for evaluating VS trainees in the operating room. Results reveal that VS masters expect far more than technical ability in the operating room when assessing their trainees for operative competency. Patient- and procedural-specific knowledge, as well as nontechnical skills, are critical determinants of VS operative competence. Current assessment tools that focus solely on technical ability are insufficient to accurately measure surgical competence. This study provides the framework for surgical educators and others involved in the assessment of surgical skill (eg, certifying bodies, credentialing committees) to design measurement tools that encompass the complex integration of KSAs that define the competent surgeon.

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