Teaching and evaluating surgical skills

Objective: To examine how surgical skills are taught and evaluated in obste trics-gynecology residency programs in the United States. Methods: A questionnaire was mailed to the directors of all 266 residency p rograms in the United States and to second contact names at 51 sites. Direc tors were asked to evaluate how surgical skills are taught and evaluated an d to rate the importance of specific techniques and procedures for resident s at given points in resident training. Results: Two hundred twenty-three surveys were returned (70%), representing 203 of 266 programs (76%). Among responding programs, 99% reported teachin g surgical skills in operating rooms, 88% in lectures, 68% with bench proce dures, and 54% with animal surgery. Twenty-nine percent indicated they had formal surgical skills curricula. A significantly higher percentage of thos e programs with formal curricula used animal surgery laboratories (81% vers us 42%, P < .001) and were more likely to conduct formal skills assessments (88% versus 69%, P = .005) than programs without formal curricula. Overall , 74% of programs evaluated surgical skills. Of those, 56% reported using s ubjective faculty evaluations, 12% written evaluations (eg, checklists), 4% written and oral assessments, and 1% a test. Regardless of formal curricul a, there was much agreement in respondents' ratings of 60 different skills and procedures as "essential," "important," "nice to know," or "unimportant ." Conclusion: Most programs teach surgical skills in the operating room and t hrough lectures. Only 29% of reporting programs provide formal surgical cur ricula. Evaluation of surgical skills is usually done by subjective evaluat ion, a technique with unknown validity and poor reliability. (C) 2000 by Th e American College of Obstetricians and Gynecologists.