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CC BY-NC-ND 4.0 · Indian J Plast Surg 2019; 52(02): 216-221
DOI: 10.1055/s-0039-1695658
Original Article
Association of Plastic Surgeons of India

Objective Assessment of Microsurgery Competency—In Search of a Validated Tool

Sheeja Rajan
1   Department of Plastic Surgery, Government Medical College, Kozhikode, Kerala, India
2   MCI Regional Centre for Medical Education Technology, Kozhikode, Kerala, India
,
Ranjith Sathyan
1   Department of Plastic Surgery, Government Medical College, Kozhikode, Kerala, India
,
L. S. Sreelesh
1   Department of Plastic Surgery, Government Medical College, Kozhikode, Kerala, India
,
Anu Anto Kallerey
3   Taluk Hospital Nadapuram, Kozhikode, Kerala, India
,
Aarathy Antharjanam
4   Taluk Hospital Pazhayangadi, Kannur, Kerala, India
,
Raj Sumitha
1   Department of Plastic Surgery, Government Medical College, Kozhikode, Kerala, India
,
Jinchu Sundar
1   Department of Plastic Surgery, Government Medical College, Kozhikode, Kerala, India
,
Ronnie Johnson John
1   Department of Plastic Surgery, Government Medical College, Kozhikode, Kerala, India
,
S. Soumya
1   Department of Plastic Surgery, Government Medical College, Kozhikode, Kerala, India
› Author Affiliations
Further Information

Publication History

Publication Date:
16 September 2019 (online)

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Abstract

Microsurgical skill acquisition is an integral component of training in plastic surgery. Current microsurgical training is based on the subjective Halstedian model. An ideal microsurgery assessment tool should be able to deconstruct all the subskills of microsurgery and assess them objectively and reliably. For our study, to analyze the feasibility, reliability, and validity of microsurgery skill assessment, a video-based objective structured assessment of technical skill tool was chosen. Two blinded experts evaluated 40 videos of six residents performing microsurgical anastomosis for arteriovenous fistula surgery. The generic Reznick's global rating score (GRS) and University of Western Ontario microsurgical skills acquisition/assessment (UWOMSA) instrument were used as checklists. Correlation coefficients of 0.75 to 0.80 (UWOMSA) and 0.71 to 0.77 (GRS) for interrater and intrarater reliability showed that the assessment tools were reliable. Convergent validity of the UWOMSA tool with the prevalidated GRS tool showed good agreement. The mean improvement of scores with years of residency was measured with analysis of variance. Both UWOMSA (p-value: 0.034) and GRS (p-value: 0.037) demonstrated significant improvement in scores from postgraduate year 1 (PGY1) to PGY2 and a less marked improvement from PGY2 to PGY3. We conclude that objective assessment of microsurgical skills in an actual clinical setting is feasible. Tools like UWOMSA are valid and reliable for microsurgery assessment and provide feedback to chart progression of learning. Acceptance and validation of such objective assessments will help to improve training and bring uniformity to microsurgery education.

Keywords

microsurgery training - objective assessment - resident education

Supplementary Material

 

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