American Association of Plastic Surgeons

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Utilizing Drawing to Evaluate Ability to Perform a Tendon Repair
Stacy Wong, M.D., Robert Weber, M.D..
Baylor Scott and White Health, TEMPLE, TX, USA.

PURPOSE: There are limited methods to safely measure operative competence outside of the operating room. Experienced plastic surgery educators frequently ask residents to draw a proposed operation. This reflects a presumption that the ability to diagram the procedure, independent of artistic ability, is indicative of the ability to perform the surgery. The purpose of this study was to delineate the relationship between the ability to draw a surgical procedure and execute it in a simulated model. METHODS: Forty participants comprised of senior medical students, plastic and orthopedic surgery residents, and hand surgery attendings, were asked to draw a tendon repair which was graded according to a modified Objective Structured Assessment of Technical Skills by a senior hand surgeon. The subjects then performed the procedure on a validated simulation model and were graded according to the Objective Structured Assessment of Technical Skills by a second senior hand surgeon blinded to the results of the drawing. Data regarding ability to draw was also obtained. Statistical analysis was performed in SAS 9.4 with Spearmanís rank correlation coefficient. RESULTS: A statistically significant positive correlation was found between the assessment of a drawing and the assessment of performing the tendon repair (p = 0.004). Of note, errors in drawing predicted errors in surgical technique. The assessment of ability to draw the procedure was not associated with previous art training or ability to draw in general (p=0.284). CONCLUSION: Having a trainee draw a procedure is a valid assessment of the surgeonís ability to perform a procedure.


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