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Assessing intraoperative judgment using script concordance testing through the gynecology continuum of practice.

Publication ,  Journal Article
Kow, N; Walters, MD; Karram, MM; Sarsotti, CJ; Jelovsek, JE
Published in: Med Teach
August 2014

OBJECTIVE: To measure surgical judgment across the Obstetrics and Gynecology (OBGYN) continuum of practice and identify factors that correlate with improved surgical judgment. METHODS: A 45-item written examination was developed using script concordance theory, which compares an examinee's responses to a series of "ill-defined" surgical scenarios to a reference panel of experts. The examination was administered to OBGYN residents, Female Pelvic Medicine and Reconstructive Surgery (FPMRS) fellows, practicing OBGYN physicians and FPMRS experts. Surgical judgment was evaluated by comparing scores against the experts. Factors related to surgical experience were measured for association with scores. RESULTS: In total, 147 participants including 11 residents, 37 fellows, 88 practicing physicians and 11 experts completed the 45-item examination. Mean scores for practicing physicians (65.2 ± 7.4) were similar to residents (67.2 ± 7.1), and worse than fellows (72.6 ± 4.2, p < 0.001) and experts (80 ± 5, p < 0.001). Positive correlations between scores and surgical experience included: annual number of vaginal hysterectomies (r = 0.32, p = <0.001), robotic hysterectomies (r = 0.17, p = 0.048), stress incontinence (r = 0.29, p < 0.001) and prolapse procedures (r = 0.37, p < 0.001). Inverse correlation was seen between test scores and years in practice. (r = -0.19, p = 0.02). CONCLUSION: Intraoperative judgment in practicing OBGYN physicians appears similar to resident physicians. Practicing physicians who perform FPMRS procedures perform poorly on this examination of surgical judgment; lower performance correlates with less surgical experience and the greater amount of time in practice.

Duke Scholars

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Published In

Med Teach

DOI

EISSN

1466-187X

Publication Date

August 2014

Volume

36

Issue

8

Start / End Page

724 / 729

Location

England

Related Subject Headings

  • Obstetrics
  • Middle Aged
  • Medical Informatics
  • Male
  • Judgment
  • Intraoperative Period
  • Humans
  • Gynecology
  • Gynecologic Surgical Procedures
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kow, N., Walters, M. D., Karram, M. M., Sarsotti, C. J., & Jelovsek, J. E. (2014). Assessing intraoperative judgment using script concordance testing through the gynecology continuum of practice. Med Teach, 36(8), 724–729. https://doi.org/10.3109/0142159X.2014.910297
Kow, Nathan, Mark D. Walters, Mickey M. Karram, Carlos J. Sarsotti, and J Eric Jelovsek. “Assessing intraoperative judgment using script concordance testing through the gynecology continuum of practice.Med Teach 36, no. 8 (August 2014): 724–29. https://doi.org/10.3109/0142159X.2014.910297.
Kow N, Walters MD, Karram MM, Sarsotti CJ, Jelovsek JE. Assessing intraoperative judgment using script concordance testing through the gynecology continuum of practice. Med Teach. 2014 Aug;36(8):724–9.
Kow, Nathan, et al. “Assessing intraoperative judgment using script concordance testing through the gynecology continuum of practice.Med Teach, vol. 36, no. 8, Aug. 2014, pp. 724–29. Pubmed, doi:10.3109/0142159X.2014.910297.
Kow N, Walters MD, Karram MM, Sarsotti CJ, Jelovsek JE. Assessing intraoperative judgment using script concordance testing through the gynecology continuum of practice. Med Teach. 2014 Aug;36(8):724–729.

Published In

Med Teach

DOI

EISSN

1466-187X

Publication Date

August 2014

Volume

36

Issue

8

Start / End Page

724 / 729

Location

England

Related Subject Headings

  • Obstetrics
  • Middle Aged
  • Medical Informatics
  • Male
  • Judgment
  • Intraoperative Period
  • Humans
  • Gynecology
  • Gynecologic Surgical Procedures
  • Female