Use of the QR Reader to Provide Real-Time Evaluation of Residents' Skills Following Surgical Procedures

摘要

What was known Educators have sought efficient approaches for busy faculty to assess and offer feedback on residents' operative skills.;What is new A streamlined portable electronic tool assessed operative skills and facilitated feedback to obstetrics-gynecology residents.;Limitations Single program sample limits generalizability; some faculty experienced problems using the electronic tool; nonvalidated satisfaction survey.;Bottom line Portable electronic evaluation is an effective tool for formative feedback and creates a longitudinal record of residents' progress.;Editor's Note: The online version of this article contains the CREOG-based Focused Assessment of Competency, a resident's evaluation on SurveyMonkey, photo of smartphone scanning a resident's TAG, and faculty survey to be completed by the resident.;Introduction Finding the optimal method for assessing the surgical skills of residents and offering them feedback has posed a challenge for decades. Early work focused on simply transferring adult learning principles to the operating room table.1 Later, more comprehensive studies emphasized establishing criteria to accurately and reliably document specific objective assessment criteria covering a full range of activities occurring immediately before, during, and following the surgical procedure.2,3 Recent initiatives have added simulation labs and videos of the operations to supplement intraoperative teaching and evaluation of operative skills.4,5 In June 2003, the Council on Resident Education in Obstetrics and Gynecology (CREOG) Competency Task Force posted recommendations for the evaluation of surgical skills of residents in obstetrics and gynecology via a surgery-focused assessment of competency (S-FAC).6 These recommendations for assessing a resident's performance during a surgical procedure consisted of evaluating the resident on specific points related to positioning the patient, sterile technique, preparing for the procedure, interacting with all members of the operative team, and technical performance (provided as online supplemental material). Although the metrics were well selected, the methods of recording performance information, adequately reviewing the assessment with the resident, and properly filing the report in the resident's educational folder will vary from institution to institution. Beyond the instruction that occurred during the operation, the resident may receive a thorough face-to-face review of the competencies by the faculty member after the procedure, or he or she may receive no postoperative discussion at all. A portable electronic format that requires direct interaction between the faculty and resident immediately following the procedure could provide a more effective assessment of surgical competencies than an evaluation performed well after the operation has concluded. The aim of this study was to judge the feasibility and acceptability of a novel electronic system for the evaluation of surgical skills.;Methods Setting and Participants This study was conducted at Louisiana State University Health Sciences Center (LSUHSC) in New Orleans, a major public medical teaching facility consisting of the Schools of Medicine, Dentistry, Public Health, Nursing, and Allied Health. The obstetrics-gynecology residents rotate to a public hospital and a private hospital in New Orleans and to a public hospital in Lafayette, Louisiana. Full-time obstetrics-gynecology faculty members supervise residents' surgeries at the 3 inpatient locations. General obstetrics and gynecology, maternal-fetal medicine, urogynecology, reproductive endocrinology, and gynecologic oncology sections are represented. During the 6-month assessment of the portable electronic surgical evaluation system, the Department of Obstetrics and Gynecology at LSUHSC comprised 25 residents and 18 full-time faculty members. For the 6-month evaluation of the paper format the previous year, there were 26 residents and 18 full-time faculty members.