A scoping review of assessment methods of competence of general surgical trainees

Background: Only rigorous evaluation of competence will result in the production of safe surgeons that are able to provide the best care for patients. The development of competency-based assessment should ultimately be evidence driven. Objectives: Explore the volume of existing evidence pertaining to the different objective assessment methods reported in the literature. Eligibility criteria: Studies describing objective assessment of postgraduate general surgical trainees within the last 20 years. Sources of evidence: PubMed, Ovid Medline and Web of Sciences. Charting methods: A data chart proforma was designed and data were extracted into tables. Basic numerical analysis of extracted data and narrative synthesis of charted data. Results: A total of 343 papers were reviewed. 26 were eligible for inclusion. 92% of articles were published from 2008 onwards. 50% have been published in the last five years. The articles originated from 6 different countries, predominantly the United Kingdom (42%), followed by the United States of America (38%). In addition, a small number were published from Canada (8%), Japan (4%), Germany (4%) and Australia (4%). UK publications were predominantly between 2008 and 2014 while the USA had a later predominance between 2015 and 2018. 42% were based on quantitative methodology, 27% had a qualitative approach while 31% had mixed analysis. There were sixteen assessment methods presented. The most common type of assessment was Objective Structured Assessments (27%), which included Objective Structured Assessment of Technical Skill (OSATS) (23%) and Objective Structured Assessment of Non-Technical Skill (4%). Procedure Based Assessment (PBA) (23%) and Entrustability Scales (23%) were also prevalent. Conclusions: This scoping review has identified a range of different assessment methods. The assessment methods with a higher volume and level of supporting evidence were OSATS, PBAs and Entrustability Scales. There was a lower volume and level of supporting evidence found within this review for the remaining assessment methods. Crown Copyright (c) 2022 Published by Elsevier Ltd on behalf of Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. This is an open access article under the CC BY-NC-ND license (http://creativecommons. org/licenses/by-nc-nd/4.0/).