Increasing recognition that practice alone is not sufficient for complex skill acquisition -e.g. microsurgical skills (rajan2019)

Microsurgery is a complex skill that needs training and deliberate practice, and some form of objective assessment of that skill is necessary for formative or summative assessment. The gold standard in practice is success rate, but that requires a series of “cases”. How do you assess one “case”?

There is no standard way of assessing microsurgical skills either in the training laboratory or clinical surgery. Assessing skill is also difficult - currently no standard method (see Rajan2019 discussion and others)

Need a criterion based score for microsurgery

Various assessment scores developed, but non widely used. difficulties - need for experts to score, either in person and via video - need for complex equipment - subjective elements to score

See some scoring systems and reviews: rajan2019: compared GRW and UWOMSA. GRS performed better in terms of intra- and inter-rater reliability, but authors recommend UWOMSA - possibly because it is specific to microsurgery. The subscores give more information to trainee and third parties about what is good or not.

It would be good to have a separation of concerns - end product versus process measures

- UBAT