A primer on standards setting as it applies to surgical education and credentialing

Background Surgical technological advances in the past three decades have led to dramatic reductions in the morbidity associated with abdominal procedures and permanently altered the surgical practice landscape. Significant changes continue apace including surgical robotics, natural orifice-based surgery, and single-incision approaches. These disruptive technologies have on occasion been injurious to patients, and high-stakes assessment before adoption of new technologies would be reasonable. Methods We reviewed the drivers for well-established psychometric techniques available for the standards-setting process. Results We present a series of examples that are relevant in the surgical domain including standards setting for knowledge and skills assessments. Conclusions Defensible standards for knowledge and procedural skills will likely become part of surgical clinical practice. Understanding the methodology for determining standards should position the surgical community to assist in the process and lead within their clinical settings as standards are considered that may affect patient safety and physician credentialing.