Objective structured assessment of technical skills for repair of fourth-degree perineal lacerations

Am J Obstet Gynecol. 2008 Dec;199(6):676.e1-6. doi: 10.1016/j.ajog.2008.07.054.

Abstract

Objective: The objective of this study was to assess the reliability and validity of an objective structured assessment of technical skills (OSATS) for repair of fourth-degree obstetric lacerations on a surgical model.

Study design: Three blinded judges reviewed recordings of 20 junior and 20 senior obstetrics-gynecology residents performing simulated perineal repairs using a beef tongue model. Judges completed task-specific OSATS and global rating scales for each repair. Six recordings were rereviewed after 2 weeks. Inter- and intrarater reliability and construct validity were assessed.

Results: Interrater reliability was 0.80 for task-specific OSATS and 0.59 for the global rating scale. Intrarater reliability was poor. Construct validity was demonstrated, with senior residents scoring higher than junior residents on task-specific OSATS (13.0 vs 10.5; P = .007) and the global rating scale (24.0 vs 19.3; P = .001).

Conclusion: We found good interrater reliability and construct validity using a task-specific OSATS for fourth-degree perineal laceration repair. This instrument shows promise as a tool for competency-based evaluations.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Cattle
  • Clinical Competence*
  • Confidence Intervals
  • Education, Medical, Graduate / methods
  • Female
  • Humans
  • Injury Severity Score
  • Internship and Residency / methods*
  • Lacerations / pathology
  • Lacerations / surgery*
  • Models, Educational
  • Observer Variation
  • Obstetric Surgical Procedures / education*
  • Perineum / injuries
  • Perineum / surgery*
  • Probability
  • Reproducibility of Results
  • Suture Techniques / education
  • Tongue