Effect of Time Lapsed on Quality of Surgical Resident Intraoperative Performance Evaluation: A Systematic Review

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OBJECTIVE:Several tools have been developed and validated to assess resident intraoperative performance and to provide formative feedback. The objective of this systematic review is to evaluate the effect of time since the completion of the case on the quality of the feedback gathered by the assessment tool.DATA SOURCES:Search English-language studies in PubMed, Cochrane, Science Direct Journals, and Ovid using keywords.METHODS OF STUDY SELECTION:Publications selected for review were published in a peer-reviewed journal, described a study involving intraoperative assessment of resident surgical training and reported on the timing of completion. Studies were excluded if they were an abstract or if the subject of study was simulation, medical students or nonsurgical residents. Two reviewers independently appraised the articles to extract relevant data.RESULTS:Three hundred sixty-one publications were identified, and three met inclusion criteria addressing the main objective. One study demonstrated that the median time to completion of evaluations was more than 11 days, with a range of 4.5–22 days. Another study demonstrated that elapsed time greater than 6 days threatened the construct validity of the assessment. The final study demonstrated the degree of item-to-item variation and the presence of formative comments were negatively affected when more than 14 days had elapsed.CONCLUSION:The amount of time elapsed between the observed operative performance and the performance evaluation can be lengthy and can negatively impact the quality of the data collected. Solutions must be sought to improve the timeliness of feedback to mitigate the impact of the delay.

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