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The examination assessment of technical competence in vascular surgery

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The European Board of Surgery Qualification in Vascular Surgery is a pan‐European examination for vascular surgeons who have attained a national certificate of completion of specialist training. A 2‐year study was conducted before the introduction of a technical skills assessment in the examination.


The study included 30 surgeons: 22 candidates and eight examiners. They were tested on dissection (on a synthetic saphenofemoral junction model), anastomosis (on to anterior tibial artery of a synthetic leg model) and dexterity (a knot‐tying simulator with electromagnetic motion analysis). Validated rating scales were used by two independent examiners. Composite knot‐tying scores were calculated for the computerized station. The stations were weighted 35, 45 and 20 per cent, respectively.


Examiners performed better than candidates in the dissection (P < 0·001), anastomosis (P = 0·002) and dexterity (P = 0·005) stations. Participants performed consistently in the examination (dissection versus anastomosis: r = 0·79, P < 0·001; dexterity versus total operative score: r = −0·73, P < 0·001). Interobserver reliability was high (α = 0·91). No correlation was seen between a candidate's technical skill and oral examination performance or logbook‐accredited scores.


Current surgical examinations do not address technical competence. This model appears to be a valid assessment of technical skills in an examination setting. The standards are set at a level appropriate for a specialist vascular surgeon. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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Document Type: Research Article

Publication date: September 1, 2006

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