Standardizing Resident Laparoscopic Hysterectomy Performance Evaluations Using Global Operative Assessment of Laparoscopic Skills

Abstract

Objective: Surgical feedback is critical for resident education, but lacks standardization. Global Operative Assessment of Laparoscopic Skills (GOALS) is used to evaluate resident training in laparoscopic cholecystectomy and appendectomy. This study examined the effectiveness of adapting GOALS for laparoscopic hysterectomy in a single residency-training program. Methods: A single-page evaluation form was used for senior resident–attending dyads who were performing laparoscopic hysterectomies together. Senior residents completed self-evaluations and attendings completed trainee evaluations after each case. A 10-item checklist detailed key steps in the operation. Evaluators used the checklist to indicate if trainees completed each step successfully. Five laparoscopic domains (GOALS) and assessment of case difficulty were scored on a 5-point scale. Overall satisfaction with resident performance was rated on a 10-point scale. Results: Over 21 months, 10 residents and 3 attendings completed 97 evaluations. The mean step completion resident score was 62% (attending score: 63%; p = 0.10), indicating agreement between operators and evaluators in case assessments. Compared to attending ratings of resident performances, residents rated themselves lower overall in the 5 laparoscopic domains (3.26 versus 3.53; p < 0.05) despite similar case difficulty estimates (2.66 versus 2.76; p = 0.43). Positive correlations between attending and resident scores indicated consistency between users. Conclusions: GOALS can standardize resident performance evaluation during laparoscopic hysterectomy. There was interevaluator agreement; trainees were more self-critical. An electronic format could make the form easier to use. (J GYNECOL SURG 20XX:000)