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TEACHING AND EVALUATING SURGICAL SKILLS

Mandel, Lynn P. PhD; Lentz, Gretchen M. MD; Goff, Barbara A. MD

GRADUATE EDUCATION
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Objective To examine how surgical skills are taught and evaluated in obstetrics-gynecology residency programs in the United States.

Methods A questionnaire was mailed to the directors of all 266 residency programs in the United States and to second contact names at 51 sites. Directors were asked to evaluate how surgical skills are taught and evaluated and to rate the importance of specific techniques and procedures for residents at given points in resident training.

Results Two hundred twenty-three surveys were returned (70%), representing 203 of 266 programs (76%). Among responding programs, 99% reported teaching surgical skills in operating rooms, 88% in lectures, 68% with bench procedures, and 54% with animal surgery. Twenty-nine percent indicated they had formal surgical skills curricula. A significantly higher percentage of those programs with formal curricula used animal surgery laboratories (81% versus 42%, P < .001) and were more likely to conduct formal skills assessments (88% versus 69%, P = .005) than programs without formal curricula. Overall, 74% of programs evaluated surgical skills. Of those, 56% reported using subjective faculty evaluations, 12% written evaluations (eg, checklists), 4% written and oral assessments, and 1% a test. Regardless of formal curricula, there was much agreement in respondents' ratings of 60 different skills and procedures as “essential,” “important,” “nice to know,” or “unimportant.”

Conclusion Most programs teach surgical skills in the operating room and through lectures. Only 29% of reporting programs provide formal surgical curricula. Evaluation of surgical skills is usually done by subjective evaluation, a technique with unknown validity and poor reliability.

There is great variation in how and when surgical skills are taught and assessed in obstetrics-gynecology residencies.

Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington.

Address reprint requests to: Lynn P. Mandel, PhD, University of Washington School of Medicine, Department of Obstetrics and Gynecology, Box 356460, Seattle, WA 98185-6460. E-mail: lmandel@u.washington.edu

Supported by Association of Professors and Obstetrics and Gynecology Abbott Medical Education Award.

Received May 21, 1999. Received in revised form October 4, 1999. Accepted October 15, 1999.

© 2000 The American College of Obstetricians and Gynecologists