Assessing Surgeon Performance During The Hands-on Surgical Training Course Using Objective Assessment Methods.
Nabil Hussein1, Osami Honjo1, Christoph Haller1, Glen Van Arsdell2, Shi-Joon Yoo1.
1The Hospital for Sick Children (Sickkids), Toronto, ON, Canada, 2UCLA Mattel Children's Hospital, Los Angeles, CA, USA.
Objective(s):Congenital heart surgery (CHS) is a technically demanding specialty. There is a need for improved training methods by implementing simulation as expectations for perfect outcomes grows. 3D-printed models have shown to be excellent training tools in CHS, however evidence supporting its use is qualitative. We demonstrate early results of quantitative assessment in the Hands On Surgical Training (HOST) course.
13 surgeons of varying experience participated in the course, led by 2 experienced cardiovascular surgeons. Each surgeon completed 6 CHS procedures on models with different pathologies (i.e. TGA, HLHS, TOF, Truncus Arteriosus and IAA). All cases were video recorded for time of procedure and post-analysis. Delegates began with TGA 1LCX2R and repeated the same procedure on the final day without proctor assistance to assess performance. Results:
11/13 delegates completed both TGA 1LCX2R cases. All delegates were quicker in the final case when compared to the first case - Mean difference (h:mm:ss) 0:22:54 (p=0.007, 95% CI 0:07:46-0:38:01). 10/13 delegates had both cases marked using an assessment tool specific to the arterial switch procedure. 8/10 delegate scores improved - Mean difference 7.6% (p=0.06, 95% CI -0.54% - 15.74%). Videos of delegates who scored lower were reviewed to see causation Conclusions:
This is the first use of quantitative assessment methods to assess surgeon performance in HOST for CHS. All delegates were significantly quicker in their repeat cases and 80% scored higher, supporting the concept of simulation and deliberate practice. Although a promising start further validation is required before possible integration into CHS curricula.