Assessment and Improvement of Surgical Residency Education
Summary
Surgical residency education has evolved towards a competency-based paradigm that emphasises not only technical skill acquisition but also cognitive reasoning, professional behaviour and systems-based practice. Assessment methods have diversified to include in-training examinations, objective structured assessments of technical skills, simulation-based evaluations and multisource feedback. These tools aim to provide timely, actionable feedback to residents and inform curriculum adjustments. Innovations such as entrustable professional activities and milestone frameworks support a structured progression from novice to independent practitioner. Educational enhancements—ranging from dedicated teaching rotations and simulation centres to adaptive e-learning platforms and question banks—have been introduced to reinforce knowledge retention and procedural competence. Global initiatives highlight the need to tailor training to resource settings, as exemplified by regional programmes in sub-Saharan Africa that integrate context-specific operative exposure and language support. Multi-institutional collaborations, including remote mock oral examinations, foster standardisation and peer learning across training centres. As surgical practice grows increasingly complex, rigorous assessment and continuous quality improvement in residency education remain essential to prepare skilled surgeons capable of delivering safe, high-quality patient care worldwide.
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Assessment and Improvement of Surgical Residency Education publication trend
The graph below shows the total number of articles in assessment and improvement of surgical residency education across all publications each year (not limited to Nature Index journals).
Technical terms
Competency-based medical education (CBME): A framework that defines progression through discrete competencies rather than time-based training intervals.
In-Training Examination (ITE): A standardised written assessment administered during residency to gauge medical knowledge and readiness for board certification.
Mock Oral Examination (MOE): A simulated high-stakes oral assessment designed to emulate certifying board interviews and enhance clinical reasoning under pressure.
Entrustable Professional Activities (EPAs): Units of professional practice that trainees are authorised to perform independently once sufficient competence is demonstrated.
References
- A Comparative American Board of Surgery In-Training Examination (ABSITE) Performance Analysis Between International vs. Domestic Graduates and Doctor of Medicine (MD) vs. Doctor of Osteopathic Medicine (DO) Medical Degrees. Cureus (2024).
- Factors Influencing Exam Performance of Surgical Trainees in Sub-Saharan Africa: A Retrospective Analysis of the College of Surgeons in East, Central, and Southern Africa Membership Examination. Journal of Surgical Education (2024).
- Examining the Most Impactful Strategies for In-service Preparation: A Systemic Review. Journal of Surgical Education (2024).
- Multi-institutional collaborative mock oral (mICMO) examination for cardiothoracic surgery trainees: Results from the pilot experience. JTCVS Open (2020).
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