Performance of residents during laparoscopic cholecystectomy: Is self-assessment reliable?


Yildirim M., Saglam A. I., Ugurlu C., Angin Y. S., Dasiran F., Okan I.

Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, cilt.31, sa.4, ss.414-420, 2021 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 31 Sayı: 4
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1097/sle.0000000000000959
  • Dergi Adı: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.414-420
  • Anahtar Kelimeler: Dunning-Kruger phenomenon, Laparoscopic cholecystectomy, Self-assessment, Surgical resident
  • Eskişehir Osmangazi Üniversitesi Adresli: Hayır

Özet

Background: To compare the self-assessment of surgical residents and observers (faculty members and nurses) during laparoscopic cholecystectomy (LC). Materials and Methods: A prospective observational study was conducted between February 2020 and July 2020 at a medical school hospital. Seventy-four LC surgeries were performed by surgical residents in the presence of faculty members. A self-assessment of the technical and nontechnical performance of the residents was requested. The self-assessment of residents was compared with observer evaluations using the Kruskal-Wallis test. Gwet AC2 fit coefficient was used to determine the consistency between the observers' and residents' assessments. Bland-Altman plots were generated with 95% limits of agreement to describe the agreement between the total scores of the observers. Results: The self-assessment of residents had a statistically significant higher score when compared with observers (faculty and nurses) (P < 0.001). However, no significant difference was observed between the total scores given by the observers (faculty members and nurses) (P > 0.05). There was a moderate agreement between the resident versus faculty members [0.503; 95% confidence interval (CI), 0.430-0.576] and resident versus nurse (0.518; 95% CI, 0.432-0.605) when evaluating technical skills. However, there was substantial agreement between faculty members and nurses (0.736; 95% CI, 0.684-0.789). Postoperative pain was significantly correlated with resident self-assessment (P = 0.022). Conclusion: The self-assessment scores of surgical residents in LC operations were overestimated compared with observer assessments.