CUSUM AS AN AID TO EARLY ASSESSMENT OF THE SURGICAL TRAINEE

Tests of knowledge, aptitude and psychomotor skills have been used to assess and select surgical trainees but none of these is reliable in t he long term. The industrial quality- control method of the cusum was used to assess performance progress in 17 surgical trainees. Trainees were assessed on their ability to perform, independently, selected sur gical operations using the criterion of procedure duration. Cusum prof iles were compared with scores from at least four independent assessor s using a modified Royal Australasian College of Surgeons' mentor form . The cusum identified all trainees who were considered either satisfa ctory or less able by their mentors. This objective evaluation was rel iable after 25 procedures, whether for appendicectomy or combined with herniorrhaphy and cholecystectomy. Evaluation of surgical performance using the cusum may prove to be a more objective tool for assessing s urgical trainees than early impressions or less clinically oriented te sts.