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Session: ePoster: Education, Training Assessment, and Practice Management 1 (Sun8)

EP278 - Evaluating the Relationship between Theatre Performance Assessments and Clinical Outcomes.

Sunday, May 11, 2025
8:49 AM – 8:54 AM PT
Location: Monitor 5, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • SH

    Shady G. Hosny, MB BS BSc MRCS FRCS PhD

    Consultant Colorectal Surgeon
    Queen's Hospital, Romford
    London, England, United Kingdom

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • HA

    Hutan Ashrafian, MB BS BSc MRCS PhD MBA

    Head of AI and Big Data at IGHI
    Imperial College London
    London, England, United Kingdom

    Disclosure information not submitted.

  • PP

    Phil HL Pucher, MD PhD MD BSc FRCS

    Consultant Upper GI Surgeon
    St Mary's Hospital
    London, England, United Kingdom

    Disclosure information not submitted.

  • DM

    Danilo Miskovic, PhD MD FRCS

    Consultant Colorectal Surgeon
    St Mark's Hospital
    London, England, United Kingdom

    Disclosure information not submitted.

    • Senior Author(s)

  • AD

    Ara Darzi, PC KBE MD FRCSI FRCS

    Co-Director of the Institute of Global Health Innovation at Imperial College London
    St Mary's Hospital
    London, England, United Kingdom

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Shady G. Hosny, MB BS BSc MRCS FRCS PhD: This individual has no financial relationships with ineligible companies.
Ara Darzi, PC KBE MD FRCSI FRCS: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: The typical surgical patient pathway during a care encounter comprises an outpatient clinic appointment, wherein decision may be made to proceed to an operative procedure followed by a ward stay and finally discharge. The shortest component of their care delivery comprises the operative encounter whereas the focus of the assessment of expertise remains within the domains of technical performance. Very few studies have been conducted that address both issues – the assessment tool and the desired clinical outcome.

Methods/Interventions: 20 expert colorectal surgeons were observed during the care encounter in pre- (clinic), intra- (theatre), and post-operative (ward round) domains. Assessments were conducted using Observed Structured Assessment of Non-Technical Skills (OSANTS) and Observed Structured Assessment of Technical Skills (OSATS) tools. Surgeon outcomes were derived from retrospective Hospital Episode Statistical data up to a maximum of 10 years (104,126 patient episodes). Mixed-effects logistic regression analysis on mortality, total complications and length of stay data to obtain the odds ratio (OR). Results were analysed using a multivariate regression. Results were considered significant when p < 0.05 and a Holmes-Bonferroni correction was applied for multiple hypothesis testing.

Results/Outcomes: Compound assessment scores were analysed. The results did not show a consistent relationship between performance scores and clinical outcomes, although there was a shortened length of stay for better OSATS scores (p = 0.0001, IRR = 1.0134 CI 1.0061 – 1.0207) when looking at all admission episodes (Table 1)

Conclusion/Discussion: Compound assessment scores using established performance assessment tools are not consistently associated with better clinical outcomes in validated technical and non-technical assessment tools. Further work is required to establish the nature of the relationship between performance assessments and clinical outcomes.