The use of error analysis to assess resident performance

Anne Lise D. D'Angelo, Katherine E. Law, Elaine R. Cohen, Jacob A. Greenberg, Calvin Kwan, Caprice Greenberg, Douglas A. Wiegmann, Carla M. Pugh

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background The aim of this study was to assess validity of a human factors error assessment method for evaluating resident performance during a simulated operative procedure. Methods Seven postgraduate year 4-5 residents had 30 minutes to complete a simulated laparoscopic ventral hernia (LVH) repair on day 1 of a national, advanced laparoscopic course. Faculty provided immediate feedback on operative errors and residents participated in a final product analysis of their repairs. Residents then received didactic and hands-on training regarding several advanced laparoscopic procedures during a lecture session and animate lab. On day 2, residents performed a nonequivalent LVH repair using a simulator. Three investigators reviewed and coded videos of the repairs using previously developed human error classification systems. Results Residents committed 121 total errors on day 1 compared with 146 on day 2. One of 7 residents successfully completed the LVH repair on day 1 compared with all 7 residents on day 2 (P = .001). The majority of errors (85%) committed on day 2 were technical and occurred during the last 2 steps of the procedure. There were significant differences in error type (P ≤ .001) and level (P = .019) from day 1 to day 2. The proportion of omission errors decreased from day 1 (33%) to day 2 (14%). In addition, there were more technical and commission errors on day 2. Conclusion The error assessment tool was successful in categorizing performance errors, supporting known-groups validity evidence. Evaluating resident performance through error classification has great potential in facilitating our understanding of operative readiness.

Original languageEnglish (US)
Article number4145
Pages (from-to)1408-1414
Number of pages7
JournalSurgery (United States)
Issue number5
StatePublished - Nov 2015
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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