Perspectives on simulation-based assessment of operative skill in surgical training. (4th March 2023)

• Record Type: Journal Article
• Authors: Toale, Conor; Morris, Marie; Kavanagh, Dara O.
• Is Part Of: Medical teacher. Volume 45:Number 3(2023)
• Page Start: 313
• Page End: 320
• Publication Date: 2023-03-04
• Subjects: Surgery -- assessment -- simulation -- competency-based education -- performance of procedures; Medical education -- Periodicals; 610.711
• DOI: 10.1080/0142159X.2022.2134001
• Languages: English
• ISSNs: 0142-159X

Abstract

Abstract: Introduction: The perspectives of the wider surgical community toward simulation-based assessment (SBA) in training is a gap in the literature. This study aims to explore the factors associated with the acceptable use of SBA in surgical training, through the perceptions and experiences of a broad range of stakeholder representatives, building on findings from a review of the published literature. Materials and methods: Ten semi-structured interviews were conducted, using a sequential transformative qualitative methods approach, with representatives from identified key stakeholder groups; executive management, risk management, a practicing surgeon, an anaesthesiologist, a theatre-nursing representative, a representative from simulation industry, a patient, a medical student, a junior surgical trainee, and a senior surgical trainee. Interview transcripts underwent reflexive thematic analysis using an inductive and constructivist framework (NVIVO software, NVIVO 12, QSR International). Results: Four themes emerged: the 'need' for SBA, the concept of a 'minimum standard', the 'optimum design' of an SBA framework, and 'fairness'. SBA is a potential solution to challenges in the current training environment. It emerged that it should not replace trainer judgement, but could ensure that trainees meet a minimum operative competency standard. SBA should be used to identify underperforming trainees early in training to provide targeted remediation. The application of SBA in high-stakes settings such as trainee selection, autonomy granting, and end-of training certification has perceived benefits over current assessment methods. Conclusions: This study builds on findings from prior research to explore factors regarding the acceptable use of simulation as an assessment method in surgical training, including perspectives from a broad range of stakeholder representatives. Findings can inform the development of simulation-based assessment curricula in surgical training.