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. 2015 Nov;158(5):1408-14.
doi: 10.1016/j.surg.2015.04.010. Epub 2015 May 21.

The use of error analysis to assess resident performance

Anne-Lise D D'Angelo  1 , Katherine E Law  2 , Elaine R Cohen  3 , Jacob A Greenberg  3 , Calvin Kwan  3 , Caprice Greenberg  3 , Douglas A Wiegmann  2 , Carla M Pugh  3
Affiliations

The use of error analysis to assess resident performance

Anne-Lise D D'Angelo et al. Surgery. 2015 Nov.

Abstract

Background: The aim of this study was to assess validity of a human factors error assessment method for evaluating resident performance during a simulated operative procedure.

Methods: Seven postgraduate year 4-5 residents had 30 minutes to complete a simulated laparoscopic ventral hernia (LVH) repair on day 1 of a national, advanced laparoscopic course. Faculty provided immediate feedback on operative errors and residents participated in a final product analysis of their repairs. Residents then received didactic and hands-on training regarding several advanced laparoscopic procedures during a lecture session and animate lab. On day 2, residents performed a nonequivalent LVH repair using a simulator. Three investigators reviewed and coded videos of the repairs using previously developed human error classification systems.

Results: Residents committed 121 total errors on day 1 compared with 146 on day 2. One of 7 residents successfully completed the LVH repair on day 1 compared with all 7 residents on day 2 (P = .001). The majority of errors (85%) committed on day 2 were technical and occurred during the last 2 steps of the procedure. There were significant differences in error type (P ≤ .001) and level (P = .019) from day 1 to day 2. The proportion of omission errors decreased from day 1 (33%) to day 2 (14%). In addition, there were more technical and commission errors on day 2.

Conclusion: The error assessment tool was successful in categorizing performance errors, supporting known-groups validity evidence. Evaluating resident performance through error classification has great potential in facilitating our understanding of operative readiness.

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Figures

Figure 1
Figure 1
Examples of procedure steps performed during the simulated LVH with corresponding images
Figure 2
Figure 2
Multimedia Video Task Analysis™ (MVTA™) user interface
Figure 3
Figure 3
Proportion of cognitive versus technical errors during each step of the procedure
See this image and copyright information in PMC

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