Orthopaedic Trainee Opinion on the Current Procedure-based Assessment Compared to its Predecessor: A UK Trauma Centre Perspective

Background Procedure-based assessments (PBAs) were introduced as a formative assessment of surgical performance. UK trainees are currently expected to complete at least 20 PBAs each training year. A new PBA tool was introduced in August 2016 in order to address several criticisms with its predecessor. These included mandatory written feedback and increasing the number of global levels of assessment. Objectives Our study sought to identify the impact of these modifications to the PBA tool on its perceived utility as a formative assessment of surgical skill. Study design & methods Orthopaedic trainee registrars (ST3-ST8) holding a UK National Training Number (NTN) at a major UK trauma centre were invited to take part in the study. Each trainee completed an anonymous questionnaire that was designed to elicit the view of trainees towards the old and new PBA. Results Twelve trainees took part in the study. Most of them admitted receiving good quality feedback from their trainer using both tools (75% old PBA; 83% ew PBA). Most trainees (58%) felt that written feedback did not encourage verbal feedback from their trainer. Overall, trainees felt the new PBA global rating scale levels had made it a more accurate measure of surgical performance and allowed them to better appreciate the gradual improvement in their surgical skills throughout their training. Conclusions Fifty per cent of the trainees believed that the new PBA overall was a better formative assessment of surgical skill than its predecessor. A significant factor has been the introduction of a new global rating score rather than efforts to improve feedback. Further work should look to identify whether these views match those of other UK-based trainees on a larger scale.