The Successful Use of a Virtual Application to Enhance Formative Feedback- and Competency-Based Assessments in Surgical Training

Abstract

INTRODUCTION: This study aimed to use a customized phone and computer application to improve formative feedback in surgery and assess competency over time. METHODS: General surgery residents at a single institution were enrolled in a prospective cohort study from August 2021 to February 2022. A survey was conducted at the beginning and conclusion of the study period to assess perceptions on feedback regarding technical skills. Afterwards, a customized phone application was used to assess competency using the Zwisch scale and a dictation feature. Salient features of the app included 15 core operations (appendectomy, cholecystectomy, hernia repair, laparotomy, etc) broken into 7-10 key steps, objective structured assessment of technical skills (OSATS), components that went well, and areas for improvement. RESULTS: Twenty-two surgery residents submitted 260 virtual feedback-forms over a six-month period. After the study, residents’ perception that they were receiving valuable, weekly feedback regarding technical skills increased from 27.2% to 100.0% (p < 0.001). The application also allowed the program to track competency over time and provide insight into critical areas for improvement (Fig. 1). Two of the most commonly dictated phrases by faculty included “make better use of your left hand,” and “remain aware of providing adequate counter-tension.” 90.9% of residents stated that the use of the virtual application enhanced their operative experience and would recommend its continued use for feedback and competency-based assessments.CONCLUSION: Phone applications greatly enhance formative, technical feedback for residents. These virtual applications can also be effectively used to assess improving competency over core operations in general surgery training.