Empirical validation of the Operative Entrustability Assessment using resident performance in autologous breast reconstruction and hand surgery

Background In 2013, we developed the Operative Entrustability Assessment (OEA) to facilitate evaluation and documentation of resident operative skills. This web-based tool provides real-time, transparent feedback to residents on operative performance. This study evaluated the construct validity of the OEA, assessing its association with operative time. Methods We used simple and multiple linear regression to estimate associations between OEA scores and operative time in selected procedures performed. Results OEAs were completed for 93 autologous breast reconstructions and 185 hand procedures. Self-assessed OEA was associated with shorter operative time in breast (p = 0.008) and hand (p = 0.036) cases. Evaluator OEA was associated with shorter operative time in breast (p = 0.018), but not hand cases (p = 0.377). Post-graduate year was not associated. Conclusions The OEA demonstrates construct validity: increasing scores are associated with shorter operative time and are better predictors of operative time than post-graduate year, making it an option for documenting competence prior to graduation.