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You are here: McMaster Institute for Music and the Mind > Publications > Training the trainers: a systematic review regarding assessment of technical skills in the operating room

C Fahim, N Wagner, M Nousianien, and RR Sonnadara (2017)

Training the trainers: a systematic review regarding assessment of technical skills in the operating room

Academic Medicine.

Introduction: Competency-based medical education (CBME) will soon be the underlying framework for surgical training curricula in North America. Trainees progress through a CBME curriculum by demonstrating competence in a variety of skills. Despite the upcoming implementation of CBME, medical educators are currently limited by the availability of assessment tools and the ability of faculty to reliably implement those tools.


Methods: A systematic review to identify all intra-operative assessment tools evaluating technical skills was completed. Data regarding assessment type, assessment feasibility, and competency scores as related to CBME were extracted. These findings were supplemented by a scoping review to identify key strategies for training faculty members on how to effectively utilize CBME assessments.


Results: A total of 32 studies were included in the review. The majority of studies reported reasonable scores of inter-rater reliability and demonstrated initial validity testing. Seven articles identified minimum scores required to establish competence. Eighteen articles commented on the role of faculty training for the accurate and timely completion of trainee assessments. Key faculty training strategies included facilitating a “cultural shift” around assessment and completing assessments in a timely manner. The scoping review did not reveal any additional articles.


Discussion: The literature identifies a number of assessment tools to evaluate technical skills.  Nevertheless, there remains a paucity of literature demonstrating how these assessment tools should be practically applied to establish competence. Further work is required to identify when and how often trainees should be assessed in a CBME curriculum. Finally, strategies to train faculty should be refined and implemented to ensure that CBME assessment tools are utilized in a standardized manner. 

surgical training, CBME
in press

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