Towards online global certification of technical surgical skills: a viable and scalable method for assessing technical surgical skills objectively using remote technology

Purpose To address the gap in surgical certification in countries where mandatory certification only consists of theoretical exams and does not assess technical skills, critical to surgical practice. We aimed to design a large-scale examination to certify surgical skills using simulation models and a digital platform for blinded, remote, and asynchronous assessment. Methods Surgeons completing their professional title revalidation in Chile underwent an eight-station Objective Structured Clinical Examination (OSCE) with simulated procedures designed to test competency levels. All procedures were recorded from two video camera angles and uploaded to a digital platform for blinded video-based remote and asynchronous assessment. Four different assessment scales were used, with a passing score set by experts at 75%. A questionnaire was also conducted to measure participants’ perceptions after the OSCE. Results Sixty-eight participants were assessed over 9 examinations, with 476 procedures performed, 884 high-resolution videos recorded and uploaded to the platform. The OSCE lasted 200 min (range180–240), with an average online assessment time per procedure of 5–8 min and 56 min per participant. Sixty-six participants (97.05%) passed the exam with a median score of 82.62% (IQR 79,52–85,79%). In addition, all participants rated the examination as very good. Conclusion This study demonstrated that it is feasible to assess a large number of specialists in a short period of time using remote and asynchronous assessment through a digital platform. Using simulation models and digital platforms to objectively assess surgical skills allows for a scalable approach that could enable large-scale examinations of technical surgical skills.