Predictors of Performance in Endoscopic Rhinology Procedures

Abstract

Objective: Investigate the best predictor of performance of otolaryngology trainees in a rhinology skills lab. Method: Cross-sectional study carried out in February 2012 where 15 trainees from the London otolaryngology training program (year 3-5) were asked to complete 9 operative tasks on a sheep head model and were assessed by 5 experts on task-specific and global performance using a previously validated tool. We tested 7 factors as predictors of performance including time (months) in surgical training, time in otolaryngology training and time in rhinology sub-speciality training, practical rhinology courses attended, total rhinology procedures, procedures as main operating surgeon, and precourse operative global scores from video recordings. Results: The task-specific and global scores correlated well (Pearson 0.66). Six out of the 7 factors did not show correlation with performance at the skills lab (time in surgery, time in otolaryngology, time in rhinology, number of courses, total procedures, and procedures performed, Pearson: 0.19, 0.12, 0.3, 0.11, 0.28, and 0.13, respectively). The only measure that correlated well is precourse performance scored blindly and independently using the same tool based on video recordings of trainees operative procedures (Pearson: 0.62) Conclusion: Predicting surgical performance is a multi-factorial complex process. The assessment process including the tool and assessors have been validated further by showing consistency in scoring the same trainee twice, before and during the course as well as good correlation between task-specific and global assessment. Previously acquired skills have the highest predictive value.