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Br J Surg. 2010 Apr;97(4):511-6. doi: 10.1002/bjs.6938.

Assessment of surgical competence at carotid endarterectomy under local anaesthesia in a simulated operating theatre.

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1
St Mary's Hospital London Regional Vascular Unit, London, UK. drsablack@hotmail.com

Abstract

BACKGROUND:

Methods of surgical training that do not put patients at risk are desirable. A high-fidelity simulation of carotid endarterectomy under local anaesthesia was tested as a tool for assessment of vascular surgical competence, as an adjunct to training.

METHODS:

Sixty procedures were performed by 30 vascular surgeons (ten junior trainees, ten senior trainees and ten consultants) in a simulated operating theatre. Each performed in a non-crisis scenario followed by a crisis scenario. Performance was assessed live by means of rating scales for technical and non-technical skills.

RESULTS:

There was a significant difference in technical skills with ascending grade for both generic and procedure-specific technical skill scores in both scenarios (P < 0.001 for all comparisons). Similarly, there was also a significant difference in non-technical skill with ascending grade for both scenarios (P < 0.001). There was a highly significant correlation between technical and non-technical performance in both scenarios (non-crisis: r(s) = 0.80, P < 0.001; crisis: r(s) = 0.85, P < 0.001). Inter-rater reliability was high (alpha > or = 0.80 for all scales).

CONCLUSION:

High-fidelity simulation offers competency-based assessment for all grades and may provide a useful training environment for junior trainees and more experienced surgeons.

PMID:
20186898
DOI:
10.1002/bjs.6938
[Indexed for MEDLINE]
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