Technical skills continue to improve beyond surgical training

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Technical skills continue to improve beyond surgical training Vikas Pandey, MB, ChB, John H.N. Wolfe, MS, Krishna Moorthy, MD, MBBS, Yaron Munz, MD, Mark J. Jackson, MD, Ara W. Darzi, MD Journal of Vascular Surgery Volume 43, Issue 3, Pages 539-545 (March 2006) DOI: 10.1016/j.jvs.2005.09.047 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 Saphenofemoral junction groin model (Limbs & Things, Bristol, UK). Tissue consists of silicone with latex fluid-filled vessels. Journal of Vascular Surgery 2006 43, 539-545DOI: (10.1016/j.jvs.2005.09.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 Imperial College Evaluation of Procedure-Specific Skill (ICEPS) rating scale for saphenofemoral junction ligation. Eight operative components on a 5-point scale. Descriptive comments at anchoring points aid marking. Journal of Vascular Surgery 2006 43, 539-545DOI: (10.1016/j.jvs.2005.09.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 Box plot for generic surgical skills. As in the following box-plots, the horizontal line represents the median value, boxes represent the interquartile ranges and whiskers, the 95% confidence intervals. The circles represent statistical outliers and the asterisk represents extreme values. Significant differences seen between senior house officers (SHO) and junior specialist registrars (JSPR) (P < 0.001) and between new consultants (NCon) and senior consultants (SCon) (P = 0.026). Journal of Vascular Surgery 2006 43, 539-545DOI: (10.1016/j.jvs.2005.09.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 4 Box plot for procedural score. Horizontal line represents median value. Boxes represent interquartile ranges and whiskers, actual range. The circle represents statistical outliers and the asterisk represents extreme values. Although scores increase with grade, significant differences are only seen between the first two groups (P < .001). SHO, Senior house officer; JSpR, Junior specialist registrar; SSpR, senior specialist registrar; Ncon, new consultant; Scon, senior consultant. Journal of Vascular Surgery 2006 43, 539-545DOI: (10.1016/j.jvs.2005.09.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 5 Box plot for total operative score. Horizontal line represents median value. Boxes represent interquartile ranges and whiskers, actual range. The circle represents statistical outliers. Significant differences are again seen between the first two groups (P < 0.01). Performance then improves (although not significantly) until completion of training. There a significant improvement in score between the newly consultants (Ncon) and senior consultant (Scon) (P = .04). SHO, Senior house officer; JSpR, Junior specialist registrar; SSpR, senior specialist registrar. Journal of Vascular Surgery 2006 43, 539-545DOI: (10.1016/j.jvs.2005.09.047) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions