Self-Assessment as a Critical Feature in Surgical Training

One of the distinguishing features of the Global Surgical Training Challenge is the requirement that the training modules include a self-assessment for learners. As part of the ongoing support to the Discovery Award teams, we assembled a panel of international experts for a workshop to help the teams understand the principles of self-assessment. The teams then worked with these experts in small groups to answer questions about this critical feature of their prototypes.

A group of 55 team members from around the world attended the workshop, which featured Professor Carla Pugh from Stanford University, Professor Richard Arnett and Dr Dara O’Keefe of the Royal College of Surgeons in Ireland, Dr Ahmed Ghazi at the University of Rochester in New York, and Professor Björn Hartmann at University of California Berkeley.

Professor Pugh kicked off the session by outlining the foundational principles of self-assessment in the context of this Challenge. 

“Self-assessment is the primary source of value to learners in designing these training prototypes.” says Dr Pugh. “We use assessment to evaluate variations in technique, which can have direct implications for patient outcomes. This impact is huge, and it’s lasting.”

The team members learned about theoretical frameworks, question design, physical models for assessment, and best practices for learning feedback. They learned the difference between teaching and feedback, cognitive task analysis and motor learning theory. The workshop addressed the importance of assessing both cognitive, or decision-making, skills as well as technical skills.

Throughout the workshop, the experts emphasized the importance of timely feedback using a holistic approach against an objective standard. The standard can be either mastery, for more experienced practicing surgeons, or competence for first year residents. Either way, assessment requires a specific measurement of skills. 

“In the end, if you can’t measure it, you can’t improve it,” says Prof.  Pugh.