An Unbiased Objective Surgical Skills and Simulation Assessment Program to Ensure Technical Skills Competency in Vascular Surgery

Document Type

Conference Proceeding

Publication Date

10-2026

Publication Title

Journal of Vascular Surgery

Abstract

Introduction: Although technical proficiency is a critical component of a competent vascular surgeon, there is presently no formal testing method to evaluate the ability of a senior vascular trainee to independently and successfully perform both endovascular and open vascular surgical procedures. We present the 10-year results of an assessment program that unbiasedly, by means of simulation, evaluates the technical abilities of graduating vascular trainees who are 6 months from completion of their training program. Our goal was to assess both competency and independence. Methods: From 2015 to 2025, a total of 332 senior PGY-5 vascular surgery residents and PGY-7 vascular surgery fellows were evaluated using simulation with multiple unbiased objective assessments. The faculty performing the evaluations consisted primarily of vascular surgery program directors and section/department chairs. No teaching occurred during the testing period. Immediate summative feedback was provided by faculty following each procedure. Trainees were assessed using procedure specific global rating scales (GRS), critical performance (CPM) and critical time metrics (CTM), and a nonspecific overall performance summary score (OPSS). Twenty-two index open vascular and endovascular surgical procedures were used to assess trainee performance (Table). After the completion of each procedure, overall competency was determined. Competency was determined by a GRS score of $80%, 100% success for all CPM and CTM, or achievement of a satisfactory proficient level OPSS. Results: Over the 10-year period of evaluation, no trainee was able to independently complete all of their testing modules in a competent manner. Based on GRS scores, a wide range of procedural failure rates were observed for the 22 simulated procedures performed (Table). Analysis of the GRS for individual procedures indicated somewhat higher operative failure performance rates occurred for endovascular procedures ranging from 18% to 39% as compared with open vascular procedures where performance failure occurred in 14% to 32% of procedures. Similarly high procedural failure rates were noted when performance was assessed by OPSS, 0%-75%, and for CPM and CTM at 29%-85%. Conclusions: A lower than expected rate of technical proficiency in the performance of simulated index vascular surgical procedures was found to exist among senior vascular trainees when they were assessed in an unbiased objective manner. These findings suggest that there are deficiencies in our present training methods as it relates to teaching and assessing technical competency. This study emphasizes the need for a standard, unbiased, technical skills assessment program to assess the technical competency of graduating vascular trainees.

Volume

84

Issue

4

First Page

e360

Last Page

e360

Comments

Eastern Vascular Society Annual Meeting, September 17-19, 2026, Washington, DC

DOI

10.1016/j.jvs.2026.06.122

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