How do Trainers and Trainees use Formative Workplace-based Assessments of Operative Competence to Deliver and Receive Structured Feedback?

Abstract

The aim of this study is to assess the quality of feedback provided to surgical trainees in the operating theatre, and to further investigate how trainees and trainers use workplace-based assessment in practice with regards to frequency and timing of assessments. A retrospective study of all submitted Supervised Structured Assessments of Operative Performance (SSAOPs) from April 25, 2016 to February 2, 2021 was conducted. Surgical trainees in the Republic of Ireland across all national surgical training sites submitted SSAOPs through an online platform. Assessments of operative competence (SSAOPs) from all Core Surgical Trainees (in their first two years of dedicated post-graduate surgical training) were included for analysis, regardless of surgical subspecialty. A total of 2294 assessments were submitted from April 25, 2016 to February 2, 2021 by 330 core surgical trainees and 379 surgeon assessors. Five hundred of these assessments were randomly selected and scored for quality of feedback using a modified "Task, Gap, Action (TGA)" framework. Of all 2294 submitted assessments, 1905 (83.04%) were submitted in the latter 3 months of each rotation, and 803 (35%) were submitted in the last month. Only 51 of 270 (18.89%) of trainees in their first year and 33 of 236 trainees in their second year (13.98%) submitted more than the minimum required number of assessments (6 per year). Of 500 randomly selected assessments, 362 (72.4%) had documented written feedback. The mean 'Gap' and 'Action' scores were low, at 0.44/3 and 0.53/3 respectively. Trainees do not submit more than the required number of operative workplace-based assessments. Assessments are submitted at the end of the trainee's rotation, limiting their formative value. The quality of written feedback is poor and could be improved significantly by encouraging a "Task," "Gap" and "Action" approach.