Objectively structured assessment of surgical skill of orthopedic postgraduates

Abstract

Introduction: Assessment of “Surgical or Operative skills” is essential for a postgraduate student in surgery and allied subjects including orthopedics. This assessment is more relevant as formative than only on the day of summative examination. However, formal and regular assessment of “Surgical or operative skills” of the postgraduate students seems to be a neglected area since it is challenging to conduct such assessment in setting like operation theatres and paucity of valid and reliable tools. In the present study, Objectively Structured Assessment of Technical Skill Score (OSATS) was used as tool to analyze the feasibility and inter observer reliability for assessment of identified surgical skill/competency of orthopedics postgraduates. Methodology: This cross-sectional study was conducted in Department of Orthopaedics of a tertiary care teaching hospital in Central India, from May to August 2018. Seven postgraduate students of the department were included in the study. Two trained faculty members observed the performance by postgraduates for a skill of “Skin suturing in a hip surgery” and scored them using Global rating scale of OSATS on a Likert scale and a Task specific checklist (TSC). Results: The mean OSATS score was 29.28 (Range 24–35). Task specific score was lower in 2nd year postgraduate (9.5) as compared to scores of 3rd year students. No statistically significant difference was found between OSATS and TSC scoring by both the observers. Inter-rater reliability using Spearman's correlation was found to be r = 0.947074863 for OSATS and 0.886844053 for TSC. There was significant difference for evaluation of OSATS and TSC scoring between JR-II and JR-III students for both the observers. Conclusion: OSATS scores along with TSC are reliable with good interobserver correlation for assessment of surgical/technical skill of orthopedic residents. Validated TSC needs to be created for all the identified technical skills to be assessed.