Mastery skill assessment in hepato-pancreato-biliary surgical ultrasound: It's a Matter of Entrustment

Ellen J Hagopian; Nicholas J Zyromski; D Rohan Jeyarajah; Eren Berber; Yoon Soo Park; Christine Park; Rachel Yudkowsky

doi:10.1016/j.amjsurg.2021.08.014

Mastery skill assessment in hepato-pancreato-biliary surgical ultrasound: It's a Matter of Entrustment

Am J Surg. 2022 May;223(5):905-911. doi: 10.1016/j.amjsurg.2021.08.014. Epub 2021 Aug 12.

Authors

Ellen J Hagopian¹, Nicholas J Zyromski², D Rohan Jeyarajah³, Eren Berber⁴, Yoon Soo Park⁵, Christine Park⁶, Rachel Yudkowsky⁷

Affiliations

¹ Hackensack Meridian School of Medicine, Department of General Surgery, 123 Metro Blvd., 4th Floor, Nutley, NJ, 07110, USA. Electronic address: Ellen.Hagopian@hmhn.org.
² Indiana University School of Medicine, Department of Surgery, 545 Barnhill Dr EH 519, Indianapolis, IN, 46202, USA. Electronic address: nzyromsk@iupui.edu.
³ Methodist Richardson Medical Center, Department of Surgery, 2805 East President George Bush Highway, Richardson, TX, 75082, USA. Electronic address: Rohanjeyarajah@gmail.com.
⁴ Cleveland Clinic, Departments of General and Endocrine Surgery, 9500 Euclid Ave/F 20, Cleveland, OH, 44195, USA. Electronic address: erenberber@sbcglobal.net.
⁵ University of Illinois at Chicago College of Medicine, Department of Medical Education, Room 986 CMET MC 591, 808 S Wood Street, Chicago, IL, 0612, USA. Electronic address: yspark2@uic.edu.
⁶ University of Illinois at Chicago College of Medicine, Departments of Anesthesiology and Medical Education, Simulation and Integrative Learning Institute, 1220 South Wood Street, 5th floor Chicago, IL, 60608, USA. Electronic address: Cpark1@uic.edu.
⁷ University of Illinois at Chicago College of Medicine, Department of Medical Education, Room 986 CMET MC 591, 808 S Wood Street, Chicago, IL, 0612, USA. Electronic address: rachely@uic.edu.

PMID: 34399979
DOI: 10.1016/j.amjsurg.2021.08.014

Abstract

Background: A formative hepato-pancreato-biliary (HPB) ultrasound (US) skills practicum is offered annually to graduating HPB fellows, using entrustment assessments for open (IOUS) and laparoscopic (LAPUS) US. It is hypothesized that validity evidence will support the use of these assessments to determine if graduating fellows are well prepared to perform HPB US independently.

Methods: Expert faculty were surveyed to set Mastery Entrustment standards for fellow performance. Standards were applied to fellow performances during two annual US skills practicums.

Results: 11 faculty questionnaires were included. Mean Entrustment cut scores across all items were 4.9/5.0 and 4.8/5.0 and Global Entrustment cut scores were 5.0/5.0 and 4.8/5.0 for IOUS and LAPUS, respectively. 78.5% (29/37) fellows agreed to have their de-identified data evaluated. Mean fellow Entrustments (across all skills) were 4.1 (SD 0.6; 2.6-4.9) and 3.9 (SD 0.7; 2.7-5), while the Global Entrustments were 3.6 (SD 0.8; 2-5) and 3.5 (SD 1.0; 2-5) for IOUS and LAPUS, respectively.

Conclusions: Two cohorts of graduating HPB fellows are not meeting Mastery Standards for HPB US performance determined by a panel of expert faculty.

Keywords: HPB surgery; HPB ultrasound; Surgical ultrasound; Surgical ultrasound assessment; Ultrasound mastery entrustment.

MeSH terms

Biliary Tract Surgical Procedures*
Biliary Tract*
Digestive System Surgical Procedures*
Humans
Laparoscopy*