The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE)

Gofton, Wade; Dudek, Nancy; Wood, Timothy J.; Balaa, Fady; Hamstra, Stanley J.

doi:10.1097/acm.0b013e3182677805

Cited by 260 publications

(198 citation statements)

References 25 publications

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“…37 And the Ottawa Surgical Competency Operating Room Score uses "knowledge of procedural steps." 38 But none of these rubrics fully capture the pattern of principles represented in this study. Moreover, many of the rubrics include potential procedural variations that could be both principle and preference.…”

Section: Acknowledging Challenges In Assessmentmentioning

confidence: 99%

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

Apramian¹,

Cristancho²,

Watling³

et al. 2016

Journal of Surgical Education

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OBJECTIVE-Clinical research increasingly acknowledges the existence of significant procedural variation in surgical practice. This study explored surgeons' perspectives regarding the influence of intersurgeon procedural variation on the teaching and learning of surgical residents.DESIGN AND SETTING-This qualitative study used a grounded theory-based analysis of observational and interview data. Observational data were collected in 3 tertiary care teaching hospitals in Ontario, Canada. Semistructured interviews explored potential procedural variations arising during the observations and prompts from an iteratively refined guide. Ongoing data analysis refined the theoretical framework and informed data collection strategies, as prescribed by the iterative nature of grounded theory research. RESULTS-Surgeons endorsed the use of intersurgeon procedural variations to teach residents about adapting to the complexity of surgical practice and the norms of surgical culture. Surgeons suggested that residents' efforts to identify thresholds of principle and preference are crucial to professional development. Principles that emerged from the study included the following: (1) knowing what comes next, (2) choosing the right plane, (3) handling tissue appropriately, (4) recognizing the abnormal, and (5) making safe progress. Surgeons suggested that learning to follow these principles while maintaining key aspects of surgical culture, like autonomy and individuality, are important social processes in surgical education. PARTICIPANTS-OurCONCLUSIONS-Acknowledging intersurgeon variation has important implications for curriculum development and workplace-based assessment in surgical education. Adapting to intersurgeon procedural variations may foster versatility in surgical residents. However, the existence of procedural variations and their active use in surgeons' teaching raises questions about the lack of attention to this form of complexity in current workplace-based assessment strategies. CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptFailure to recognize the role of such variations may threaten the implementation of competencybased medical education in surgery.

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Section: Acknowledging Challenges In Assessmentmentioning

confidence: 99%

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

Apramian¹,

Cristancho²,

Watling³

et al. 2016

Journal of Surgical Education

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“…Newer tools have been developed to help meet these challenges, such as multi-source feedback for team skills and communication, 8 narrative feedback for patient-centered care, communication, and professionalism, 9 and the Ottawa Surgical Competency Operating Room Evaluation for operative competency. 10 Clearly, medical educators have made progress on developing tools to assess different areas of competence, not just the easier competencies to assess such as medical knowledge (ACGME) or the CanMEDS medical expert role.…”

Section: Assess What Is Important Not Just What Is Easymentioning

confidence: 99%

Assessment Pearls for Competency-Based Medical Education

Humphrey‐Murto

Wood

Ross

et al. 2017

Journal of Graduate Medical Education

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“…29 The Ottawa Score, which uses a 5-point scale assessing readiness for independent practice, had a standard deviation for technical performance score of 1.01. 30 In laparoscopic surgery, a 6-point scale with the amount of support required had an inter-rater reliability score of 0.87. 31 The inter-rater Cronbach's Alpha for the 4 raters on the 2 cases for all video metrics (time, number of shots, pullbacks, cortex head breaches, switch between AP/lateral shots, supervisor instruction to others, supervisor instructions to surgeon, supervisor handle of instruments, and overall supervisor impact score) was 0.99, which compares quite favorably to these other techniques, suggesting that the techniques proposed may enjoy even greater inter-rater consistency than OSATS.…”

Section: Discussionmentioning

confidence: 99%

Assessing Wire Navigation Performance in the Operating Room

Taylor

Thomas

Karam

et al. 2016

Journal of Surgical Education

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Objective-There are no widely accepted, objective, and reliable tools for measuring surgical skill in the operating room (OR). Ubiquitous video and imaging technology provide opportunities to develop metrics that meet this need. Hip fracture surgery is a promising area in which to develop these measures because hip fractures are common, the surgery is used as a milestone for residents, and it demands technical skill. The study objective is to develop meaningful, objective measures of wire navigation performance in the OR.Design-Resident surgeons wore a head-mounted video camera while performing surgical open reduction and internal fixation using a dynamic hip screw. Data collected from video included: duration of wire navigation, number of fluoroscopic images, and the degree of intervention by the surgeon's supervisor. To determine reliability of these measurements, four independent raters performed them for two cases. Raters independently measured the tip-apex distance (TAD), which reflects the accuracy of the surgical placement of the wire, on all 7 cases. Setting-University of Iowa Hospitals and Clinics in Iowa City, IA -a public tertiary academic center.Participants-Seven surgeries were performed by seven different orthopaedic residents. All ten raters were biomedical engineering graduate students.Results-The means and standard deviations for AP, lateral, and combined TAD measurements of the 10 raters were 2.7, 1.9, and 3.7 mm, respectively, and inter-rater reliability produced a Cronbach's Alpha of 0.97. The inter-rater reliability analysis for all 9 video-based measures produced a Cronbach's Alpha of 0.99.Conclusions-Several video-based metrics were consistent across the four video reviewers and are likely to be useful for performance assessment. The TAD measurement was less reliable than previous reports have suggested but remains a valuable metric of performance. Non-experts can reliably measure these values and they offer an objective assessment of OR performance.

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The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE)

Cited by 260 publications

References 25 publications

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

Assessment Pearls for Competency-Based Medical Education

Assessing Wire Navigation Performance in the Operating Room

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