Objective surgical skill assessment: the diagonal operating matrix.

Published on Apr 1, 2007in Interactive Cardiovascular and Thoracic Surgery1.675
· DOI :10.1510/ICVTS.2006.141002
Sharif Al-Ruzzeh2
Estimated H-index: 2
(LGI: Leeds General Infirmary),
Shishir Karthik8
Estimated H-index: 8
(LGI: Leeds General Infirmary),
David J. O'Regan27
Estimated H-index: 27
(LGI: Leeds General Infirmary)
Sources
Abstract
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 on the y-axis as four levels. PAR defines three skills at each level. Each skill is graded from 1–3 (this may be taken as below average, average, above average). The skills at various levels are: Level 0 – Posture, Address, Relaxation; Level 1 – Pick-up, Airtime, Rotation; Level 2 – Placing, Angles, Rhythm; Level 3 – Precision, Adaptability, Reproducibility; Level 4 – Pace, Awareness, Relations. The PAR-DOM matrix provides a graphic representation of the progress of trainees over their training period assigned for them to stay with the trainer and also help identify individual strengths and weaknesses. 2007 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
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Introduction: Compliance with the European Working Time Directive has made obvious the need for a surgical skills training system that will produce surgeons fast and reliably. We have previously proposed a model for objective assessment of surgical dexterity. In this paper we aim to place an updated version of that model into the context of a holistic approach on assessment of a trainee’s progress towards becoming an independently operating surgeon. Methods: The PAR matrix breaks down an operati...
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