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

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.