Identifying novel metrics of operative performance in surgical training: protocol for a Delphi consensus study

Introduction: Acquiring the technical and non-technical skills necessary to perform operations safely requires time and dedication. The learning curve is steep and regular feedback on operative performance is needed to help trainees identify strengths and development needs. Traditional methods of assessment are time consuming, prone to bias and lack reliability and scalability. Advances in digital technology in surgery have allowed for more objective measures of operative performance to be generated. Objective performance metrics can provide insights void of opinion and can complement and strengthen traditional methods of feedback. This protocol outlines a study that aims to reach consensus on which performance metrics are most relevant to surgical trainees and how they should be applied in training. Methods and analysis: A three-round electronic Delphi study will be used. Participants will be asked to rate the importance of statements relating to objective performance metrics in surgical training and the ways in which they could be applied. Statements will be created from extensive searches of the literature, discussion with experts and through a pilot. A panel consisting of trainees, trainers, researchers and institutions will be formed to participate in the study. Ethics and dissemination: Formal ethical approval has been granted for this study. Dissemination will be at surgical and education meetings, in addition to publication following peer review.