Sandeep Ganni1, Sanne M B I Botden2, Dennis P Schaap3, Bas H Verhoeven2, Richard H M Goossens4, Jack J Jakimowicz5. 1. Medisign, Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands; Department of Surgery, GSL Medical College, Rajahmundry, India; Research and Education, Catharina Hospital, Eindhoven, The Netherlands. Electronic address: s.ganni@tudelft.nl. 2. Department of Paediatric Surgery, Radboud University Medical Center-Amalia Children's Hospital, Nijmegen, The Netherlands. 3. Research and Education, Catharina Hospital, Eindhoven, The Netherlands. 4. Medisign, Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands. 5. Medisign, Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands; Research and Education, Catharina Hospital, Eindhoven, The Netherlands.
Abstract
OBJECTIVE: To establish whether a systematized approach to self-assessment in a laparoscopic surgical skills course improves accordance between expert- and self-assessment. DESIGN: A systematic training course in self-assessment using Competency Assessment Tool was introduced into the normal course of evaluation within a Laparoscopic Surgical Skills training course for the test group (n = 30). Differences between these and a control group (n = 30) who did not receive the additional training were assessed. SETTING: Catharina Hospital, Eindhoven, The Netherlands (n = 27), and GSL Medical College, Rajahmundry, India (n = 33). PARTICIPANTS: Sixty postgraduate year 2 and 3 surgical residents who attended the 2-day Laparoscopic Surgical Skills grade 1 level 1 curriculum were invited to participate. RESULTS: The test group (n = 30) showed better accordance between expert- and self-assessment (difference of 1.5, standard deviation [SD] = 0.2 versus 3.83, SD = 0.6, p = 0.009) as well as half the number (7 versus 14) of cases of overreporting. Furthermore, the test group also showed higher overall mean performance (mean = 38.1, SD = 0.7 versus mean = 31.8, SD = 1.0, p < 0.001) than the control group (n = 30). The systematic approach to self-assessment can be viewed as responsible for this and can be seen as "reflection-before-practice" within the framework of reflective practice as defined by Donald Schon. CONCLUSION: Our results suggest that "reflection-before-practice" in implementing self-assessment is an important step in the development of surgical skills, yielding both better understanding of one's strengths and weaknesses and also improving overall performance.
OBJECTIVE: To establish whether a systematized approach to self-assessment in a laparoscopic surgical skills course improves accordance between expert- and self-assessment. DESIGN: A systematic training course in self-assessment using Competency Assessment Tool was introduced into the normal course of evaluation within a Laparoscopic Surgical Skills training course for the test group (n = 30). Differences between these and a control group (n = 30) who did not receive the additional training were assessed. SETTING: Catharina Hospital, Eindhoven, The Netherlands (n = 27), and GSL Medical College, Rajahmundry, India (n = 33). PARTICIPANTS: Sixty postgraduate year 2 and 3 surgical residents who attended the 2-day Laparoscopic Surgical Skills grade 1 level 1 curriculum were invited to participate. RESULTS: The test group (n = 30) showed better accordance between expert- and self-assessment (difference of 1.5, standard deviation [SD] = 0.2 versus 3.83, SD = 0.6, p = 0.009) as well as half the number (7 versus 14) of cases of overreporting. Furthermore, the test group also showed higher overall mean performance (mean = 38.1, SD = 0.7 versus mean = 31.8, SD = 1.0, p < 0.001) than the control group (n = 30). The systematic approach to self-assessment can be viewed as responsible for this and can be seen as "reflection-before-practice" within the framework of reflective practice as defined by Donald Schon. CONCLUSION: Our results suggest that "reflection-before-practice" in implementing self-assessment is an important step in the development of surgical skills, yielding both better understanding of one's strengths and weaknesses and also improving overall performance.
Keywords:
Interpersonal and Communication Skills; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; evaluation; expert assessment; laparoscopic cholecystectomy; laparoscopic skills; self-assessment; training
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