Video-Based Assessment May Improve Dermatology Resident Surgical Skills

The use of video-based assessment in evaluating surgical skills and safety of dermatology residents offers an avenue for more comprehensive clinical feedback, which may help to improve surgical skills and reduce the risk for unsafe practices, according to research from a study published in the Journal of the American Academy of Dermatology.

Researchers sought to demonstrate the applicability of video-based assessment in providing dermatology residents with feedback on surgical technical skills and unsafe surgical practices. In total, 12 residents (8 women) were recruited and separated by postgraduate year (PGY); 4 were PGY-2, 5 were PGY-3, and 3 were PGY-4.

The residents were each recorded performing an excision and intermediate linear closure on the trunk or extremity of a patient while wearing a head-mounted point-of-view camera. Following the procedure, each resident completed a self-evaluation consisting of a structured assessment of technical skills and a global assessment scale. Two blinded dermatology faculty independently reviewed each recording and rated the residents using the same assessments in addition to completing a safety checklist.

Inter-reviewer ratings were averaged for comparison with resident self-scores. Median scores for each PGY level were obtained from the average of the self and faculty survey questions, and the median scores were compared by PGY level. There were a total of 35 unsafe events, averaging 2.69 events (1.37±0.38) per resident. PGY-2 and PGY-3 residents demonstrated an average of 2.8 unsafe events per trainee, whereas PGY-4 residents showed decreased unsafe events with an average of 2.3 per trainee. The self-evaluations of all PGY groups rated higher than faculty assessments on 12 of 15 evaluations examined, and there was a significant positive correlation in PGY level and faculty scores (correlation coefficient 0.49; P <.0001). There was no significant correlation in PGY level and self-evaluation scores.

Study limitations include the small sample size and the surgical safety checklist used, which is not a validated measurement tool.

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The researchers concluded that video assessment of resident surgical procedures is a unique and effective method in providing objective evaluation of surgical technical skills and identifying unsafe surgical practices. The review of these videos provides the opportunity of intentional self-review and comprehensive individualized faculty feedback to improve surgical skills and safety. Future research may incorporate the use of video recording and assessment to determine if the resulting feedback leads to improved surgical skills and reduced incidence of unsafe surgical practices.

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Chitgopeker P, Sidey K, Aronson A, et al. Surgical skills video-based assessment tool for dermatology residents: a prospective pilot study [published online March 20, 2020]. J Am Acad Dermatol. doi: 10.1016/j.jaad.2019.08.048