Modified OSATS assessment and remediation program for general surgery interns

Background General surgery interns begin residency with variable levels of basic surgical knowledge and technical skill. Through our modified Objective Structured Assessment of Technical Skill (OSATS) curriculum, we have created a comprehensive intern assessment and novel remediation program with the goal of standardizing interns’ knowledge and skill at the start of residency training. Methods An expert panel of attending surgeons determined 10 critical aspects of surgical care that an intern is expected to perform. Scoring rubrics were adapted from the OSATS for these skills. All interns were paired with a senior resident to meet for 6 weeks of deliberate practice-based instruction and then assessed early in the academic year. Interns performing below the level of their peers were defined as a score of less than 80% on a given task, requiring remediation on the task. Three months later, interns were reassessed. Further coaching was performed until all interns met a minimum standard of proficiency in all domains. Results From 2016 to 2023, 126 interns participated in the program. On initial assessment, 77% (97/126) of interns performed below the level of their peers on at least one skill. The most common areas of lower performance varied by year. Overall, the most common areas of underperformance included two-handed knot-tying (35%, 44/126 deficient), plain film interpretation (33%, 29/126 deficient) and running subcuticular (29%, 35/126 deficient). Conclusions We have created an intern assessment and remediation program that identifies areas of deficiency for interns’ operative skills and clinical knowledge. Through iterative remediation, our program brings interns to a baseline level of surgical competency for optimal clinical performance.