Criterion-Based (Proficiency) Training to Improve Surgical Performance

Systematic review of skills transfer after surgical simulation-based training

“…Thirteen studies 31 -43 investigated endoscopic procedures, including colonoscopy 36,40,43 , oesophogastroduodenoscopy 32,38,39,41 , cystourethroscopy 37 , flexible transnasal laryngoscopy 31,35 , endoscopic sinus surgery 33,42 and transurethral resection of prostate (TURP) 34 ( Table 2). Seven studies 44 -50 investigated other procedures, namely knee arthroscopy 46 , abdominal fascial closure 49 , cardiac catheterization 44 , superficial femoral artery angioplasty 47 and cataract surgery 45,48,50 (Table 3).…”

Assessing Technical Competence in Surgical Trainees

“…125 In the reviewed literature and in other publications, most definitions have embedded within them a minimum standard needed to be safe and/or the ability to perform the operation independently without help. 31,35,45,48,51,53,55,56,[58][59][60][61][62]64,87,103,[105][106][107]109,110,[113][114][115] Surgical competence has been described as a collection of skill, knowledge, and judgment required to complete new or familiar tasks incorporating both technical and nontechnical (ie, clinical problem solving) components. [119][120][121] Furthermore, operative competence builds on this definition but also includes a surgeon's experience and opportunities to form a broader, more universal domain.…”

“…The expert benchmark studies assessed competence in multiple disciplines including General Surgery, 31,[72][73][74][75][76][77][78][79][80][81][82][83][84] Gynecology, 78,83,85,86 Otolaryngology, 87 and Urology. 78,83 The majority of studies assessed the technical competence of categorical and/or preliminary surgical trainees performing a basic task (ie, knot tying) or generic procedure (ie, laparoscopic suturing) without a clear discipline focus or breakdown of participating residents.…”

“…78,83 The majority of studies assessed the technical competence of categorical and/or preliminary surgical trainees performing a basic task (ie, knot tying) or generic procedure (ie, laparoscopic suturing) without a clear discipline focus or breakdown of participating residents. [88][89][90][91][92][93][94][95][96][97][98] The platforms utilized were live performances on virtual reality, 72,73,75,79,81,83,84,86,90,92,95,96,98 synthetic models (box trainers), 31,[76][77][78]80,82,85,89,91,94 simulators, 74,87 or a combination of synthetic models and a virtual reality platform. 97 Two studies utilized live assessments performed on standardized bench models.…”

“…31,35,45,48,51,53,55,56,[58][59][60][61][62]64,87,103,[105][106][107]109,110,[113][114][115] Differentiating competence from proficiency in the reviewed literature demonstrated that a proficient performer is one who approaches expertise and is thus at an advanced stage compared with a competent performer. 56,62,66,67,69,73,75,76,78-80,82-84,87-89,92-94, 96,97,100,113,116 …”