Generating a Prioritised List of Operative Procedures for Simulation-Based Assessment of General Surgery Trainees through Consensus

Abstract

Objective: to develop appropriate content for high-stakes simulation-based assessments of operative competence in general surgery training through consensus. Summary Background Data: Valid methods of summative operative competence assessment are required by competency-based training programmes in surgery. Method: An online Delphi consensus study was conducted. Procedures were derived from the competency expectations outlined by the Joint Commission on Surgical Training (JCST) curriculum 2021, and subsequent brainstorming. Procedures were rated according to their perceived importance, perceived procedural risk, how frequently they are performed, and feasibility, by a purposive sample of thirty surgical trainers and a five-person steering group. A modified Copenhagen Academy for Medical Education and Simulation Needs Assessment Formula (CAMES NAF) was applied to generated data in order to produce ranked procedural lists, which were returned to participants for re-prioritization. Results: Prioritised lists were generated for simulation-based operative competence assessments at two key stages of training; end of ‘phase 2’ prior to development of a sub-specialty interest, and end of ‘phase 3’ i.e. end-of-training certification. A total of 21 and 16 procedures were deemed suitable for assessments at each of these stages respectively. Conclusions: This study describes a national needs assessment approach to content generation for simulation-based assessments of operative competence in general surgery using Delphi consensus methodology. The prioritised procedural lists generated by this study can be used to further develop operative skill assessments for use in high-stakes scenarios such as trainee progression, entrustment and end-of-training certification prior to subsequent validity testing.