Resident Participation in Cadaveric Temporal Bone Dissection Correlates With Improved Performance on a Standardized Skill Assessment Instrument :

To determine the feasibility, validity, and reliability of an evaluation tool for the assessment of competency in mastoid surgery. This study tests the hypothesis that residents of dissimilar training levels differ in their technical performance as measured by this tool.

There is great interest in training surgeons in the technical aspects of their craft through simulation and laboratory-based exercises. However, there are as yet only a few objective tools to assess technical performance in a laboratory setting. This study assesses three potential objective assessment tools for a traditional otolaryngology laboratory exercise, temporal bone drilling. We performed a validation study in an academic training program. Nineteen otolaryngology residents performed a cortical mastoidectomy on a cadaveric temporal bone. The participants were divided into two groups, experienced and novice, based on previous temporal bone drilling experience. Performance was rated by two independent, blinded experts using four different assessments, the Global Rating Scale (GRS), the Task-Based Checklist (TBC), the final product analysis (FPA), and expert opinion (EO). The interrater reliability for all four assessments was good. Two potential objective assessments, the GRS and the TBC, and the traditional assessment tool of EO, correlated with trainee experience. The FPA, however, did not correlate with trainee experience. A logistic regression analysis of all assessments showed that the TBC correlates with EO. This study validates EO, the GRS, and the TBC as measures of temporal bone drilling performance. Of these measures, the TBC correlates best with EO according to logistic regression and can be reliably used as an objective assessment of temporal bone drilling.

To determine the feasibility and validity of an objective assessment tool designed to measure the development of mastoidectomy skills by resident trainees in the operating room.