Transatlantic comparison of the competence of surgeons at the start of their professional career

Author:

Schijven M P1,Reznick R K2,ten Cate O Th J3,Grantcharov T P2,Regehr G24,Satterthwaite L5,Thijssen A S3,MacRae H M2

Affiliation:

1. Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

2. Department of Surgery, University of Toronto, Toronto, Canada

3. Centre for Research and Development of Education, University Medical Centre Utrecht, Utrecht, The Netherlands

4. Wilson Centre for Research in Education, University of Toronto, Toronto, Canada

5. University of Toronto Surgical Skills Centre at Mount Sinai Hospital, University of Toronto, Toronto, Canada

Abstract

Abstract Background Although the objective in European Union and North American surgical residency programmes is similar—to train competent surgeons—residents' working hours are different. It was hypothesized that practice-ready surgeons with more working hours would perform significantly better than those being educated within shorter working week curricula. Methods At each test site, 21 practice-ready candidate surgeons were recruited. Twenty qualified Canadian and 19 qualified Dutch surgeons served as examiners. At both sites, three validated outcome instruments assessing multiple aspects of surgical competency were used. Results No significant differences were found in performance on the integrative and cognitive examination (Comprehensive Integrative Puzzle) or the technical skills test (Objective Structured Assessment of Technical Skill; OSATS). A significant difference in outcome was observed only on the Patient Assessment and Management Examination, which focuses on skills needed to manage patients with complex problems (P < 0·001). A significant interaction was observed between examiner and candidate origins for both task-specific OSATS checklist (P = 0·001) and OSATS global rating scale (P < 0·001) scores. Conclusion Canadian residents, serving many more working hours, perform equivalently to Dutch residents when assessed on technical skills and cognitive knowledge, but outperformed Dutch residents in skills for patient management. Secondary analyses suggested that cultural differences influence the assessment process significantly.

Funder

Richard and Elizabeth Currie Chair in Health Professions Education Research

Publisher

Oxford University Press (OUP)

Subject

Surgery

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