The examination assessment of technical competence in vascular surgery

Abstract

recognizable risk factor such as surgery or trauma. Given the risks of long-term anticoagulant, it is desirable to identify which patients with idiopathic VTE are particularly prone to recurrence. If this study can be confirmed by others, measurement of thrombin generation may prove to be a relatively simple method of stratifying patients for length of anticoagulation after a first time episode of idiopathic VTE. Evaluated were 30 vascular surgeons, including 22 candidates for certification, and 8 examiners. Each was tested on dexterity and ability to perform a vascular anastomosis and dissection pertinent to a vascular procedure. Dissection was tested on a synthetic saphenofemoral junction model. The ability to perform an anastomosis was assessed using an anterior tibial artery of a synthetic leg model. Dexterity was tested using a knot-tying simulator with electromagnetic motion analysis. Validated rating scores were used by two independent examiners for each area. The technical points of the examination were weighted as listed: 35% for dissection, 45% for anastomotic competence, and 20% for dexterity. The examination assessment of technical competence in vascular surgeryExaminers performed better than the candidates for certification with respect to dissection (P Ͻ .001) anastomosis (P ϭ .002) and dexterity (P ϭ .005). No correlation was observed between technical skills tested by this examination and scores on the oral certifying examination.Comment: The authors point out that it seems silly not to assess technical skills in a certifying examination for a surgeon. Nevertheless, it is extremely unusual for technical skills to be assessed in a national certifying surgical examination. Before implementing this type of assessment, it seems prudent to correlate results of scores from this examination with established surgeons' morbidity and mortality rates, as well as rates of technical error in day-to-day practice. I know of no movement to incorporate a technical skills examination into the current North American certifying examination for vascular surgery.Cloning the arterial IgA antibody response during acute Kawasaki disease Rowley AH, Shulman ST, Garcia FL, et al.

Self-Assessment of Technical Skill in Surgery: The Need for Expert Feedback

“…10 It does, however, remain possible that this skill can be adequately evaluated on critical self-assessment.…”

“…[6][7][8] Pre-requisites to the examination included the possession of a Certificate of Completion of Specialist Training (CCST) issued by one of the member states of the European Union and personal experience of index procedures in vascular surgery evaluated using logbook accreditation. 8 A technical skills component to this examination was validated in a 2-year pilot study 9,10 and formally introduced in 2004 as an integral part of the fellowship examination. 2.…”

Competence assessment of senior vascular trainees using a carotid endarterectomy bench model

“…Performance was assessed using post hoc blinded video analysis by four independent assessors. The Objective Structural Assessment of Technical Skill scale and a procedure-specific scale, the Imperial College Evaluation of Procedure Specific Skill for carotid endarterectomy, were used for assessment 4 . Both scales consisted of eight categories, with five points per category (maximum total of 40 for both scales).…”

The European medical specialist examination in vascular surgery

“…All candidates admitted to the examination also have a 1-day oral and practical examination, which includes questioning of theoretical background knowledge and its practical application. This takes place mostly in the context of specific clinical case studies, as well as via practical examinations on lifelike models and the following procedures are examined: an infrarenal aortic anastomosis, a carotid endarterectomy (CEA) and a crural bypass anastomosis on pulsatile perfused lifelike models [3,4,[10][11][12]14]. In the endovascular part, the applicants ability to introduce a guidewire into the renal artery is assessed [13].…”