Feasibility of Real-Time Measurement of Technical Skills in Flexible Endoscopy using a Smart Phone Application

Background: Documentation of operative proficiency is important in surgery training. Our institution developed a smart phone application to provide real time GAGES scores of residents performing flexible endoscopy. Objective: Establish the feasibility of integrating the usage of this innovation application into the workflow of busy, academic clinician educator surgeons. Methods: This is a prospective, pilot study that occurred from February 2017 through August 2017. Four attending surgeons participated. After initial training, no additional reminders were given to the faculty. Data collected were the number of evaluations completed by each faculty member, the date and time of each evaluation, and the actual GAGE score for each resident. Descriptive statistics were used to describe the distribution of evaluations and ratings. Ease of use was evaluated by conducting unstructured interviews. Results: During the study period, four attending surgeons (100%) completed 239 (43% of all available endoscopies [558]) evaluations on 21 residents (100% of residents on service were included). Of the evaluations completed, 163 used the GAGES upper endoscopy form, and 76 used the GAGES lower endoscopy form. Of the 239 evaluations, additional comments were made on 91 (38%) of the evaluations. Conclusion: This study shows the feasibility of using real-time smartphone application to evaluate resident’s skill using GAGES scores. Future steps include opening this smart phone application to all members of the department of surgery and use it throughout the residency. Incorporation of the real time GAGES scores into the 6-month summative evaluation that the Clinical Competency Committee performs would be ideal.