Assessment of Operative Autonomy and Readiness for Independent Practice Among Pediatric Surgery Fellows

The purpose of this study was to evaluate the implementation of the System for Improving and Measuring Procedural Learning (SIMPL) “app” in a pediatric surgery training program. SIMPL is a novel workplace-based operative performance assessment platform which allows case by case assessment of trainees using three scales (autonomy, performance, and case complexity) and takes seconds to complete. A pediatric surgery-specific procedural taxonomy for SIMPL was developed from the ACGME procedural library. SIMPL was piloted and implemented in a single pediatric surgery training program. A descriptive analysis of the operative assessments was undertaken. In the year following SIMPL implementation, 565 (39% of cases) assessments were completed by 21 faculty for 3 fellows for 148 unique procedures within a median of 8.5 h. Recorded feedback accompanied 61% of assessments. 2nd year fellows were more likely to be deemed autonomous (81% ratings) and practice ready (84%) vs. 1st year fellows (50%; p