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Craniofacial Skills: Validating an Assessment to Aid Plastic Surgery Resident Milestone Achievement in Technical Skills and Instrument Knowledge.

Katherine Grunzweig MD, Ji Son MD, Anand Kumar MD
University Hospitals Cleveland Medical Center
2018-02-14

Presenter: Katherine Grunzweig

Affidavit:
"I certify that Katherine Grunzweig did the majority of the original work of this project, including conception, literature search, data collection, writing, analysis and revision."

Director Name: Anand Kumar

Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial

Background: Plastic surgery evaluates residents on milestones. Previously, we defined a model of education including pre and post-test assessments and a single day of lab training intended for evaluating residents in the unique technical skills for craniofacial surgery. This study aims to validate this task-based assessment using solely Saw Bones (TM) and brief instructor education on common technical pitfalls of craniofacial surgery.

Methods: Three tasks were evaluated: instrument identification (channel retractor, lamina spreader, double guarded nasal osteotome, Obegesser in tow retractor, J inferior border mandible stripper), accuracy of burr hole placement, and accuracy of square craniotomy on craniofacial models. Tasks were evaluated before and after a short teaching simulation by the craniofacial faculty on standard osteotomies, instrument names, and pitfalls of craniofacial surgery. The study population consisted of junior, mid-level, and senior residents with different levels of experience on the University craniofacial service.

Results: Participant performance was analyzed for each post-graduate year, and was grouped by level of training: junior, midlevel and senior resident. Resident accuracy improved for all tasks (instrument naming p=0.00002, burr holes p=0.0031, craniotomy p=0.08). There was no difference in rate of improvement between resident cohorts. Data and feedback was provided to all residents after the post-assessment to guide future improvement.

Conclusion: The task-based assessment with resident education on basic craniofacial surgery skills, standard osteotomies, and instrument names directed resident learning and assessed resident knowledge. The craniofacial skills task-assessment successfully evaluated milestone attainment.

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