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Busy Operative Competency Evaluation Committee pursues three major initiatives in 2014
Dr. Patricia RobertsBy Patricia L. Roberts, MD, Chair

The ASCRS Operative Competency Evaluation Committee has been very busy and has three main initiatives for the upcoming year.

COSATS
Following on the success of the two previous pilot studies, a third COSATS examination will be administered in September 2014 at the Northwestern University Center for Advanced Surgical Education in Chicago to all first-time takers of the oral examination of the American Board of Colon and Rectal Surgery. The Colorectal Objective Structured Assessment of Technical Skills (COSATS) is a simulation-based exam of technical skills in which candidates complete eight technical skills essential to the practice of colon and rectal surgery. Examination of the entire examinee cohort will provide key information as we move to assessment of technical skills for high stakes examinations.

Two prior COSATS pilot studies have been performed and have demonstrated good reliability and validity. The first pilot study compared the technical performance of graduating general surgery chief residents and graduating colon and rectal residents and demonstrated the ability to effectively discriminate technical skills (A novel approach to assessing technical competence of colorectal surgery residents: the development and evaluation of the Colorectal Objective Structured Assessment of Technical Skills (COSATS) Ann Surg 2013; 258 (6): 1001-6). A second pilot study evaluated 37 colorectal residents who voluntarily participated in the COSATS examination administered at the time of the American Board of Colon and Rectal Surgery Oral examination in September 2012. The COSATS is an innovative approach and is the first test of its kind assessing subspecialty surgical skills at the certification level.

Development of a video-based tool for assessment of laparoscopic colorectal resection
The structured step-wise approach to laparoscopic colectomy (LC) and ability to video record cases make this an ideal procedure for objective assessment of performance. Lack of consensus of the best method of assessment of performance of laparoscopic colorectal resection on a national scale and within colorectal surgery is a major impediment to improving training in this area. This project will use video-based review of laparoscopic colectomy to develop an objective assessment tool for the technical performance of the procedure. The specific aims of the project are:

  • To assess inter-rater reliability, validity and feasibility of previously published assessment tools for laparoscopic colectomy;
  • To develop and validate a novel or modified scoring system (ASCRS tool) for laparoscopic colectomy videos that demonstrates inter-rater reliability, feasibility, and construct validity;
  • To determine how this new assessment tool can be utilized for the more consistent evaluation of colorectal residents, Board-eligible colorectal surgeons, surgeons taking advanced laparoscopic colorectal courses, and potentially those participating in maintenance of certification (MOC) cycles to provide proof of competence in these procedures.

Development of virtual reality (VR) simulator for laparoscopic colectomy
Surgical Science Inc. recently approached the leadership of ASCRS to collaborate on the development and implementation of a new virtual reality (VR) simulator for laparoscopic colectomy. Prior VR simulators have been developed independently. Surgical Science requested that ASCRS take an active and leadership role from the infancy stages of development to the final stages of validity. A sub-committee of members of the Operative Competency Evaluation Committee recently met with the engineering team and product development manager at Surgical Science. During this comprehensive strategic planning session, the groups outlined the details of this collaborative effort and identified the specific goals of the project as they pertain to training and assessment with a new VR model. This is an exciting opportunity for the ASCRS to collaborate on the development of a laparoscopic colectomy simulator.

In addition to Dr. Roberts, members of the Operative Competency Assessment Committee are Vice Chair Dr. Ann Lowry, St. Paul, MN, Advisor Dr. Richard Reznick, Kingston, ON, Canada, Council Rep Dr. Steven Wexner, Weston, FL, and Drs. Glenn Ault, Los Angeles, CA, Jennifer Beaty, Omaha, NE, Marcus Burnstein, Toronto, ON, Canada, Peter Cataldo, Burlington, VT, Bradley Champagne, Cleveland, OH, Hueylan Chern, San Francisco, CA, Bradley Davis, Cincinnati, OH, Conor Delaney, Cleveland, OH, Sandra de Montbrun, Toronto, ON, Canada, Eric Dozois, Rochester, MN, Gary Dunn, Oklahoma City, OK, James Fleshman, Dallas, TX, Rebecca Hoedema, Grand Rapids, MI, Gerald Isenberg, Philadelphia, PA, Helen MacRae, Toronto, ON, Canada, Najjia Mahmoud, Philadelphia, PA, Jorge Marcet, Tampa, FL, Michelle Olson, Urbana, IL, Jan Rakinic, Springfield, IL, Craig Reickert, Detroit, MI, David Schoetz, Jr. (ex-officio), Burlington, MA, Scott Steele, Fort Lewis, WA, Scott Strong, Cleveland, OH, and Judith Trudel, St. Paul, MN.