Assessment of surgical skills training: A call for quality improvement for educators in low- and middle-income countries

Abstract

We read with keen interest the article by Tom R. Okello and colleagues on the assessment of their final-year medical students after Essential Surgical Skills training.1 We commend the authors, the training institution, and their partners for their contributions to surgical training in the region. In their article, the authors noted the need to evaluate the effectiveness of such training programmes in terms of skills acquisition and confidence among the trainees. Using a selfadministered questionnaire, they demonstrated an improvement in the trainees’ pretraining and posttraining confidence in performing a variety of essential surgical skills. Whereas confidence is required for performing surgical procedures, it is also important to assess that the taught skills have actually been acquired by the trainees in the first place. However, no measure of the actual skills acquisition was undertaken. Selfreported assessments as used in this article tend to be subjective and are prone to a number of biases. Moreover, there was no mention of the validity or reliability of the questionnaire used for assessment. The need to assess medical skills training courses cannot be overemphasized. However, such assessment needs to be conducted in an objective manner using reliable, valid, and widely accepted tools.2 Over the years, the evolution of the assessment of surgical skills training has led to development of several tools. Examples include objective structured clinical examination (OSCE), the mini-clinical evaluation exercise (mini-CEX), the System for Improving and Measuring Procedural Learning (SIMPL), and the Objective Structured Assessment of Technical Skills (OSATS), among others