The objective assessment of surgical skill

There are many facets to being a skilful surgeon. Knowledge of anatomy, pat hophysiology, operative theory and practice are all of vital importance. In addition, skills in decision-making, communication and team-leadership are all needed. Psychomotor manual dexterity is also of importance, particular ly when considering the field of minimal-access surgery (MAS). There isa gr owing need to be able to assess surgical 'skill', both for the purposes of training and for the maintenance of exemplary practice. Attempts by academi a and industry to produce systems to give an objective assessment of surgic al 'skill' have been fraught with difficulty. Objectively assessing such a multifaceted phenomenon as 'surgical skill' produces many problems. This ar ticle aims to highlight some of the difficulties encountered when trying to produce a system of objective assessment, with a particular focus on MAS, and describes some of the solutions that have been described.