Objective: To determine whether structured and supervised cadaveric surgical training improves technical skills in expert and self-assessments and enhances self-perception of surgical trainees.
Study design: Prospective observational study.
Sample population: Seven small animal ECVS residents and surgical interns.
Methods: A cadaveric orthopedic training program, consisting of six supervised training sessions, weekly self-directed training, and one one-to-one training session with direct feedback, was conducted over 3 months. Each participant performed a set of surgical procedures on feline cadavers before and after the training period. The procedures were videotaped and subsequently evaluated by three board-certified surgeons (expert assessment [EA]) and the participants themselves (self-assessment [SA]) using the objective structured assessment of technical skills (OSATS) global rating scale (GRS). OSATS GRS scores were analyzed using the Wilcoxon signed-rank test, Kruskal-Wallis test, and Cohen's kappa coefficient (Κ).
Results: Comparing pre- and post-training assessments, median EA scores increased from 17/35 to 23/35 (p = .001). Median SA scores increased from 17/35 to 25/35 (p = .018). There was slight to substantial inter-assessor agreement (Κ = 0.04-0.65) and poor agreement between SA and EA (Κ = 0).
Conclusion: Trainee surgeons improved their technical skills in expert and self-assessments. However, the interassessor agreement was strong for only two of the three assessors. Despite limitations, the OSATS GRS enhanced the objectivity of technical surgical skills assessment.
Clinical significance: This study represents the first step in devising a meaningful training outside the operating room for veterinary surgical residents. The OSATS GRS as an assessment tool warrants further investigation.
