Gaps in Plastic Surgery Training: A Comparative Literature Review of Assessment Tools in Plastic Surgery and General Surgery

Assessment tools grading technical and non-technical skills, such as operative technique and professionalism, are well-established in general surgery. Less is known regarding the application of these tools in plastic surgery training. This study is a comparative review of the most prevalent assessment tools and rubrics utilized in general and plastic surgery. Two parallel systematic reviews of the literature utilizing PubMed and Cochrane were conducted for articles published between 1990 and 2022. Searches used Boolean operators specific to assessment tools in general and plastic surgery. Fourteen studies met inclusion criteria for general surgery assessment tools, and 21 studies were included for plastic surgery assessment tools. Seven studies (50%) evaluated technical skills in general surgery while 15 studies (71%) assessed technical skills in plastic surgery with commonality found in evaluation of principles, such as tissue and instrument handling and operative flow. Task-specific evaluation tools were described for both general and plastic surgery. Five studies evaluated non-technical skills such as communication and leadership in general surgery, while no plastic surgery studies solely examined non-technical assessment tools. Our literature review demonstrates standardized skill assessments in plastic surgery is lacking compared to those available in general surgery. Plastic surgery programs should consider implementing competency-based assessment tools in surgical coaching and training for technical and non-technical skills. More research is necessary in plastic surgery to optimize the evaluation of non-technical skills.