Assessment of operative competency for thyroidectomy: Comparison of resident self-assessment vs attending surgeon assessment

Head Neck. 2020 Dec;42(12):3551-3557. doi: 10.1002/hed.26420. Epub 2020 Aug 19.

Abstract

Background: Self-awareness of skill, essential for progression as a surgeon, has direct bearing on postresidency practice; however, studies have supported that residents achieve self-perceived competence later than believed by program directors. This study compares residents' self-perception of operative competency to attending surgeon's evaluation using Computer Enhanced Visual Learning, a validated online hemithyroidectomy-specific assessment tool.

Methods: Eleven otolaryngology-Head and Neck Surgery (HNS) residents completed a preoperative module and postoperative survey, later reviewed by an attending surgeon. Eighty-three performances were assessed for inter-rater reliabilities of key surgical steps.

Results: Almost perfect agreement (Kappa = 0.81-1.00) was shown in 11 of 18 parameters. Substantial agreement (Kappa = 0.61-0.80) was demonstrated in the remaining seven parameters.

Conclusions: Otolaryngology-HNS trainees have high self-awareness of their performance at each step in a hemithyroidectomy. Standardized assessment tools can allow for documentation of procedural performance and serve as guides for improvement. This is the only study to examine otolaryngology-HNS trainees' self-perceived skill compared to an attending surgeon's assessment for hemithyroidectomy.

Keywords: hemithyroidectomy; operative competency; resident education; surgical education; thyroidectomy.

MeSH terms

  • Clinical Competence
  • Humans
  • Internship and Residency*
  • Self-Assessment
  • Surgeons*
  • Thyroidectomy