The challenge of objective assessment of surgical skill

Abstract

Technical performance in surgery has come under increased scrutiny in recent years, not least due to several highly publicized cases where it has been suggested that poor outcomes were the result of inadequate technical skill [ 1 Hamdorf J.M. Hall J.C. Acquiring surgical skills. Br J Surg. 2000; 87: 28-37 Crossref PubMed Scopus (177) Google Scholar , 2 Parsa C.J. Organ C.H. Barkan H. Changing patterns of resident operative experience from 1990 to 1997. Arch Surg. 2000; 135: 570-575 Crossref PubMed Scopus (41) Google Scholar , 3 Smith R. All changed, changed utterly. British medicine will be transformed by the Bristol case. BMJ. 1998; 316 ([editorial] [see comments]): 1917-1918 Crossref PubMed Scopus (256) Google Scholar ]. In the Bristol case, which involved a pediatric cardiac surgery unit, the concerns voiced by a member of medical staff have now resulted in disciplinary action against two surgeons by the General Medical Council, and a judicial inquiry, which is yet to hand down its report (www.bristol-inquiry.org.uk). The resulting debate, both public and within the profession, has focused on the need for objective and independent assessment of surgical skill, and a significant research interest has developed in this area.