Assessment of Operative Autonomy and Readiness for Independent Practice Among Pediatric Surgery Fellows

Abstract

PurposeThe purpose of this study was to evaluate the implementation of the System for Improving and Measuring Procedural Learning (SIMPL) “app” in a pediatric surgery training program. SIMPL is a novel workplace-based operative performance assessment platform which allows case by case assessment of trainees using three scales (autonomy, performance, and case complexity) and takes seconds to complete. MethodsA pediatric surgery-specific procedural taxonomy for SIMPL was developed from the ACGME procedural library. SIMPL was piloted and implemented in a single pediatric surgery training program. A descriptive analysis of the operative assessments was undertaken. ResultsIn the year following SIMPL implementation, 565 (39% of cases) assessments were completed by 21 faculty for 3 fellows for 148 unique procedures within a median of 8.5 h. Recorded feedback accompanied 61% of assessments. 2nd year fellows were more likely to be deemed autonomous (81% ratings) and practice ready (84%) vs. 1st year fellows (50%; p < 0.001 both), with improvements over time. ConclusionWithin pediatric surgery, this is the first implementation of a workplace-based operative performance assessment “app”. With its ease of use, SIMPL drastically increased the volume of operative evaluations and diversified the mix of cases evaluated while SIMPL ratings demonstrated expected and graduated performance improvements over time. Type of studyEducation. Level of evidenceN/A.