Graduate educationDevelopment of an objective structured assessment of technical skills for obstetric and gynecology residents☆
Section snippets
Materials and methods
All 24 obstetrics and gynecology residents from the University of Washington participated in the assessment. There were six residents from each postgraduate year. Examinations were scheduled from 4:00 pm to 8:00 pm; six residents were tested in each session, which allowed them to be excused from clinical duties and have adequate coverage for clinical services.
We developed a seven-station examination of technical skills that included laparoscopic (port placement, intracorporeal knot,
Results
Mean global examination scores for the procedures are shown in Table 1. Scores were significantly lower for hypogastric ligation and intracorporeal knot tying. Scores were significantly higher for salpingo-oophorectomy. The mean checklist, global, and pass-fail scores for each residency level are shown in Table 1, Table 2, Table 3.
The one-way analysis of variance with Student-Newman-Keuls post hoc test was used to evaluate construct validity, the ability of the test to distinguish among
Discussion
In a recent survey of obstetrics and gynecology residency directors in the United States,11 we found that most programs rely on subjective faculty assessment of residents’ technical skills. Only 17% used testing or a standardized assessment, and 25% did not assess technical skills of residents. Observation of surgical skills without grading criteria has poor reliability. Without structured criteria, two surgeons rating the same resident typically will have a low level of agreement.1
At the
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Supported in part by a grant from the National Board of Medical Examiners (NBME) Medical Education Research Fund Grant. The project does not necessarily reflect NBME policy and NBME support provides no official endorsement. Supported in part by a grant from United States Surgical Corporation, Norwalk, Connecticut.