Measuring Performance: Current Practices in Surgical Education

Assessment requirements within the domain of surgery are equal in complexity and scope to the performance domain itself. There are numerous performance requirements in each of the cognitive, motor, and affective dimensions, and equally complex requirements for integration across a broad spectrum of performance contexts. Current assessment practices largely focus on the cognitive dimensions; however, there are initiatives and developing trends that include assessment of motor and affective dimensions as training program components. Precision of measurement remains challenging in all performance dimensions, with concomitant constraints on the accuracy and justness of assessment outcomes as definitive confirmation of performance competency in the domain. Increasing the accuracy and precision of assessment instrumentation and defining explicit performance criteria within the domain will lead to improved assessment implementation and value to surgeons, patients, and other stakeholders.