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• W3093829655 abstract "To the Editor: Current resident evaluation systems are based on subjective assessments without clear delineation of the surgical ability that defines proficiency and thus remain highly variable between evaluators and programs. The Objective Structured Assessment of Technical Skills (OSATS) tool is a validated measure of technical proficiency among trainees in multiple specialties.1Alam M. Nodzenski M. Yoo S. Poon E. Bolotin E. Objective structured assessment of technical skills in elliptical excision repair of senior dermatology residents: a multirater, blinded study of operating room video recordings.JAMA Dermatol. 2014; 150: 608-612Crossref PubMed Scopus (32) Google Scholar, 2Martin J.A. Regehr G. Reznick R. et al.Objective structured assessment of technical skill (OSATS) for surgical residents.Br J Surg. 1997; 84: 273-278Crossref PubMed Scopus (1729) Google Scholar, 3Dagnaes-Hansen J. Mahmood O. Bube S. et al.Direct observation vs. video-based assessment in flexible cystoscopy.J Surg Educ. 2018; 75: 671-677Crossref PubMed Scopus (9) Google Scholar, 4Liu K.J. Tkachenko E. Waldman A. et al.A video-based, flipped classroom, simulation curriculum for dermatologic surgery: a prospective, multi-institution study.J Am Acad Dermatol. 2019; 81: 1271-1276Abstract Full Text Full Text PDF PubMed Scopus (24) Google ScholarWe conducted a prospective, multi-institutional, multirater, rater-blinded assessment of video recordings of dermatology residents performing elliptical excisions of benign lesions on the trunk or extremities with subsequent closure. Five fellowship-trained dermatologic surgeons scored deidentified videos using the previously published OSATS global rating scale (GRS) and suture task checklist (STC).1Alam M. Nodzenski M. Yoo S. Poon E. Bolotin E. Objective structured assessment of technical skills in elliptical excision repair of senior dermatology residents: a multirater, blinded study of operating room video recordings.JAMA Dermatol. 2014; 150: 608-612Crossref PubMed Scopus (32) Google Scholar The reliability among raters across all residents was assessed using the intraclass correlation coefficient, specifically the ICC(2,k) metric. Mean ratings were compared by year of residency using the Kruskal-Wallis test, and by months of surgical training completed at the time of the recording using the Spearman rank correlation coefficient.Across 20 evaluated videos, GRS had an ICC of 0.84, and the STC had an ICC of 0.62. Higher GRS scores were associated with higher STC scores (RSpearman = 0.71; P = .0004). There was a significant correlation between the GRS (P = .01) and the STC (P = .02) scores with the years of residency (Fig 1). Years of dermatology residency correlated with the following GRS scale criteria: respect for tissue (P = .05), time and motion (P = .05), instrument handling (P = .02), flow of operation/forward planning (P = .03), and knowledge of the specific procedure (P = .004). There was a statistically significant correlation between the number of months of dermatologic surgery completed and the proficiency of residents in time and motion (P = .05), instrument handling (P = .005), use of assistants (P = .03), and knowledge of the specific procedure (P = .006). There was an increase of GRS (P = .003) and STC (P = .04) scores with more advanced (2-4 months) compared with beginner (0-2 months) dermatologic surgery training.Our study suggests that OSATS is a reliable and easy-to-use tool to measure surgical skill and competency of dermatology trainees. The high agreement among 5 experts that practice across different geographic and academic settings further gives credence to the objectivity of the OSATS tool. A set task and a uniform checklist for the examiners ensures a level playing field for residents performing the procedure and evaluators conducting the assessments. Assessment of video-recorded procedures allows for anonymity of the trainee, unbiased assessments, convenience for the reviewer, the ability to rewatch specific segments necessary for evaluation, and the opportunity to utilize multiple evaluators. It also yields more consistency in residency evaluations, allowing the surgical director to properly and objectively evaluate trainees, even if the surgery was performed under supervision of other attendings. This approach could serve to complement the current ACGME (Accreditation Council for Graduate Medical Education) milestone tools and clinical competency committees in residency training programs whereby a single attending physician or committee is tasked with assessing competency of trainees often based on other people's subjective assessments. Overall, the OSATS is a low-cost, efficient assessment method for residency surgical skills and should be considered as an evaluation tool for dermatology residents. To the Editor: Current resident evaluation systems are based on subjective assessments without clear delineation of the surgical ability that defines proficiency and thus remain highly variable between evaluators and programs. The Objective Structured Assessment of Technical Skills (OSATS) tool is a validated measure of technical proficiency among trainees in multiple specialties.1Alam M. Nodzenski M. Yoo S. Poon E. Bolotin E. Objective structured assessment of technical skills in elliptical excision repair of senior dermatology residents: a multirater, blinded study of operating room video recordings.JAMA Dermatol. 2014; 150: 608-612Crossref PubMed Scopus (32) Google Scholar, 2Martin J.A. Regehr G. Reznick R. et al.Objective structured assessment of technical skill (OSATS) for surgical residents.Br J Surg. 1997; 84: 273-278Crossref PubMed Scopus (1729) Google Scholar, 3Dagnaes-Hansen J. Mahmood O. Bube S. et al.Direct observation vs. video-based assessment in flexible cystoscopy.J Surg Educ. 2018; 75: 671-677Crossref PubMed Scopus (9) Google Scholar, 4Liu K.J. Tkachenko E. Waldman A. et al.A video-based, flipped classroom, simulation curriculum for dermatologic surgery: a prospective, multi-institution study.J Am Acad Dermatol. 2019; 81: 1271-1276Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar We conducted a prospective, multi-institutional, multirater, rater-blinded assessment of video recordings of dermatology residents performing elliptical excisions of benign lesions on the trunk or extremities with subsequent closure. Five fellowship-trained dermatologic surgeons scored deidentified videos using the previously published OSATS global rating scale (GRS) and suture task checklist (STC).1Alam M. Nodzenski M. Yoo S. Poon E. Bolotin E. Objective structured assessment of technical skills in elliptical excision repair of senior dermatology residents: a multirater, blinded study of operating room video recordings.JAMA Dermatol. 2014; 150: 608-612Crossref PubMed Scopus (32) Google Scholar The reliability among raters across all residents was assessed using the intraclass correlation coefficient, specifically the ICC(2,k) metric. Mean ratings were compared by year of residency using the Kruskal-Wallis test, and by months of surgical training completed at the time of the recording using the Spearman rank correlation coefficient. Across 20 evaluated videos, GRS had an ICC of 0.84, and the STC had an ICC of 0.62. Higher GRS scores were associated with higher STC scores (RSpearman = 0.71; P = .0004). There was a significant correlation between the GRS (P = .01) and the STC (P = .02) scores with the years of residency (Fig 1). Years of dermatology residency correlated with the following GRS scale criteria: respect for tissue (P = .05), time and motion (P = .05), instrument handling (P = .02), flow of operation/forward planning (P = .03), and knowledge of the specific procedure (P = .004). There was a statistically significant correlation between the number of months of dermatologic surgery completed and the proficiency of residents in time and motion (P = .05), instrument handling (P = .005), use of assistants (P = .03), and knowledge of the specific procedure (P = .006). There was an increase of GRS (P = .003) and STC (P = .04) scores with more advanced (2-4 months) compared with beginner (0-2 months) dermatologic surgery training. Our study suggests that OSATS is a reliable and easy-to-use tool to measure surgical skill and competency of dermatology trainees. The high agreement among 5 experts that practice across different geographic and academic settings further gives credence to the objectivity of the OSATS tool. A set task and a uniform checklist for the examiners ensures a level playing field for residents performing the procedure and evaluators conducting the assessments. Assessment of video-recorded procedures allows for anonymity of the trainee, unbiased assessments, convenience for the reviewer, the ability to rewatch specific segments necessary for evaluation, and the opportunity to utilize multiple evaluators. It also yields more consistency in residency evaluations, allowing the surgical director to properly and objectively evaluate trainees, even if the surgery was performed under supervision of other attendings. This approach could serve to complement the current ACGME (Accreditation Council for Graduate Medical Education) milestone tools and clinical competency committees in residency training programs whereby a single attending physician or committee is tasked with assessing competency of trainees often based on other people's subjective assessments. Overall, the OSATS is a low-cost, efficient assessment method for residency surgical skills and should be considered as an evaluation tool for dermatology residents. We thank Dr Christopher Xanthos and Dr Steven He (Weill Cornell Medicine) for their help with the study coordination. We also thank Senior Biostatistician Michael Evans, MS, for performing the statistical analysis for this project." @default.
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• W3093829655 title "A blinded, multirater and multi-institutional study evaluating the Objective Structured Assessment of Technical Skills (OSATS) tool in dermatology education" @default.
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