Objective surgical skill assessment: the diagonal operating matrix☆

There is an urgent need for structured surgical training and assessment due to the reduction in the training duration with the European Working Time Directive (EWTD). We propose a model for objective skill assessment, the PAR-Diagonal Operating Matrix (PAR-DOM) which breaks down the task of vascular anastomosis into clearly defined skills. The PAR-DOM is made up of a 3×5 table and progress is made along vectors defined on the x-axis as PAR and...