Eur J Pediatr Surg 2021; 31(01): 025-033
DOI: 10.1055/s-0040-1715438
Original Article

Are Self-Assessment and Peer Assessment of Added Value in Training Complex Pediatric Surgical Skills?

1   Department of Pediatric Surgery, Radboudumc, Nijmegen, The Netherlands
Guus M. J. Bökkerink
2   Department of Pediatric Surgery, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands
Bas H. Verhoeven
1   Department of Pediatric Surgery, Radboudumc, Nijmegen, The Netherlands
Jonathan Sutcliffe
3   Department of Pediatric Surgery, Leeds General Infirmary, Leeds, United Kingdom
Ivo de Blaauw
1   Department of Pediatric Surgery, Radboudumc, Nijmegen, The Netherlands
Sanne M. B. I. Botden
1   Department of Pediatric Surgery, Radboudumc, Nijmegen, The Netherlands
› Author Affiliations


Introduction Self-assessment aids “reflection-before-practice,” which is expected to result in a better understanding of one's strengths and weaknesses and consequently a better overall performance. This is, however, rarely used in surgical training. This study aims to evaluate the correlation between self-, peer-, and expert assessment on surgical skills of pediatric surgical trainees.

Materials and Methods A competency assessment tool for the posterior sagittal anorectoplasty (CAT-PSARP) was previously developed and validated. During international hands-on pediatric colorectal workshops in 2019 and 2020, participants practiced the PSARP on an inanimate anorectal malformation model. They were assisted by a peer and assessed by two independent expert observers, using the CAT-PSARP. After the training session, both self- and peer assessment were completed, using the same CAT-PSARP.

Results A total of 79 participants were included. No correlation was found between the overall CAT-PSARP scores of the expert observers and the self-assessment (r = 0.179, p = 0.116), while a weak correlation was found between experts and peer assessment (r = 0.317, p = 0.006). When comparing the self-assessment scores with peer assessment, a moderate correlation was found for the overall performance score (r = 0.495, p < 0.001). Additionally, the participants who were first to perform the procedure scored significantly better than those who trained second on the overall performance (mean 27.2 vs. 24.4, p < 0.001).

Conclusion Participants, peers, and experts seemed to have a unique view on the performance during training because there was little correlation between outcomes of the trainees and the experts. Self-assessment may be useful for reflection during training; however, expert assessment seems to be essential for assessment of surgical skills.

Publication History

Received: 12 May 2020

Accepted: 01 July 2020

Publication Date:
09 August 2020 (online)

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