Development and validation of objective structured assessment of technical skills (OSATS) for laparoscopic para-umbilical hernia repair for postgraduate general surgery residents at tertiary care hospital in Karachi

Date of Award

8-2025

Degree Type

Thesis

Degree Name

Master of Health Professions Education (MPHE)

First Advisor

Dr Shazia Babar

Second Advisor

Dr Aliya Aziz

Third Advisor

Dr Sana Saeed

Department

Educational Development

Abstract

Background: Laparoscopic para-umbilical hernia repair has become the preferred technique due to its better clinical results, including reduced postoperative pain, faster recovery, and lower infection rates. Despite the growing emphasis, many institutions, including PAF Faisal Base Hospital in Karachi, still rely on traditional assessment methods, which are often subjective and  lack procedural specificity. As a result, residents receive inconsistent assessments and little feedback, especially when it comes to advanced laparoscopic abilities. This emphasizes the need for an objective method of assess ing technical skills. Objective: This study aimed to develop and validate an Objective Structured Assessment of Technical Skills (OSATS) tool for assessing postgraduate general surgery residents performing laparoscopic para-umbilical hernia repair. The tool was designed to ensure consistency, objectivity, and relevance in assessing technical competencies while addressing the training gaps identified in local surgical education settings.
Methods: A validation design was employed, encompassing tool development and expert validation. The OSATS tool and global rating scale were designed through literature review and expert consensus using the Delphi method. Two Delphi rounds were conducted with 23 expert surgeons from various institutions. This was followed by a pilot study (workshop) at the skills laboratory FRPMC, involving postgraduate residents of PAF Faisal Base Hospital and Ziauddin Hospital. Inter-rater reliability, content validity index (CVO, and internal consistency (Cronbach's alpha) were calculated.
Results: The final OSATS tool demonstrated excellent content validity (S-CVI: 0.922), strong internal consistency (Cronbach's  alpha: 0.904 and 0.892 for two assessors respectively), and moderate inter-rater reliability (ICC: 0.499). No statistically significant difference was found between Year Ill and IV residents' overall scores.
Conclusion: This study findings revealed that this OSATS tool is a reliable and valid method for assessing laparoscopic hernia repair skills among surgical residents. Its application can enhance residents' skill development, improve assessment transparency, and ultimately contribute to safer surgical care. Implementing such structured assessment tools within academic and training institutions may strengthen postgraduate surgical education and bridge the gap between clinical training and operative proficiency.

First Page

1

Last Page

65

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