Procedure-based Assessment Implementation in Colorectal Surgery

Abstract

Competency-based training (CBT) marks a shift from time-dependent teaching to achieving proficiency based on defined surgical standards—a significant evolution in 21st-century surgical education. As this framework becomes integral to various Australian training schemes, understanding its challenges is crucial. Technical proficiency in colorectal procedures demands a trainee to possess unique skills and expertise. It is equally challenging for the supervisors to assess the trainees’ performance without bias and entrust them based on objective assessment criteria. Procedure-based assessment (PBA) is a meticulous decision-making process to ensure the progression of competency towards independently performing a unique procedure.

We conducted a 19-question survey involving Australian general and colorectal surgeons to grasp their perspectives on Procedure-Based Assessment (PBA), a key entrustment-based methodology in CBT. Our study, comprising 201 participants, highlights the challenges and behaviours surrounding PBA engagement. This critically analyses the insights of general and colorectal surgeons and identifies factors affecting the implementation of CBT in Australian surgical training centres. The findings reveal a growing comfort among supervisors in making entrustment decisions due to their increased engagement in the process. General and colorectal surgeons may share an approach to competency assessment while using PBA; however, their characteristics also contribute to certain differences.

This research aims to provide valuable insights by offering a comprehensive view of the feasibility of PBA. By addressing the challenges and attitudes of assessors, the thesis aims to inform regulators about aligning technical assessments with contemporary training systems. This knowledge of the early phases of implementation will ensure the long-term sustainability of Computer-based training (CBT).