Objective assessment of mastoidectomy skills in the operating room

Howard W. Francis, Hamid Masood, Kashif N. Chaudhry, Kulsoom Laeeq, John P. Carey, Charles C. Della Santina, Charles J. Limb, John K. Niparko, Nasir I. Bhatti

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


OBJECTIVE(S):: To determine the feasibility and validity of an objective assessment tool designed to measure the development of mastoidectomy skills by resident trainees in the operating room. STUDY DESIGN:: Prospective longitudinal validation study. SETTING:: Tertiary referral center and residency training program. SUBJECTS:: Otolaryngology residents. MAIN OUTCOME MEASURE:: Technical performance as measured over time using Task-Based Checklist (TBC) and Global Rating Scale (GRS) developed for assessment of mastoidectomy skills. RESULTS:: Seventy pairs of evaluations were completed on 15 residents, showing strong correlation between both instruments (r = 0.93; p < 0.0001). Our instrument demonstrated construct validity for both TBC and GRS, showing higher scores with increasing surgical experience in otology. Both instruments showed high interitem reliability with Cronbach α coefficients of 0.98 and 0.95 for TBC and GRS, respectively. Regression analysis showed that thinning posterior external auditory canal (p < 0.05) and opening antrum to deepen dissection at sinodural angle (p < 0.05) were the strongest predictors of overall surgical performance. CONCLUSION:: Our assessment tool is a feasible and valid method of evaluating acquisition of mastoidectomy skills in the operating room. It can be integrated into surgical teaching in the operating room and yields information for direct formative feedback.

Original languageEnglish (US)
Pages (from-to)759-765
Number of pages7
JournalOtology and Neurotology
Issue number5
StatePublished - Jul 2010


  • Competence
  • Evaluation
  • Mastoidectomy
  • Objective structured assessment of technical skills
  • Operating room
  • Otolaryngology
  • Surgical education

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Sensory Systems
  • Clinical Neurology


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