Madison Objective Self-Assessment Tool: A Reliable and User-Friendly Approach for Objective Self-Assessment in Microvascular Anastomosis Training

BACKGROUND AND OBJECTIVES: Thorough and objective assessment is of utmost importance for any microsurgical laboratory training, allowing trainees to identify areas needing further improvement. The ideal assessment tool should be objective, reliable, self-administered, and easy to implement. Building on this necessity, the aim of this study was to establish an objective, reliable, and self-administered assessment tool for microsurgical laboratory training, enabling trainees to independently practice and assess their own results. METHODS: Eight trainees completed the Baskaya Microvascular Bypass Training Curriculum using a basic microsurgery training kit. Each trainee evaluated their 31 end products twice with the newly introduced Madison Objective Self-Assessment Tool (MOST). Subsequently, the same expert independently evaluated each trainee's end products once. These 3 sets of evaluations were compared using the intraclass correlation coefficient (ICC) to determine the reliability of the new self-assessment tool, both intrarater and interrater. RESULTS: The findings demonstrated that, aside from 2 exercises, the agreement levels for both interrater and intrarater ranged from excellent (ICC >0.90) to acceptable (ICC = 0.61-0.80). For the silicone tube (2 mm) end-to-end anastomosis with 9-0, the interrater ICC showed fair agreement, at 0.32 [−0.10 to 0.63], and for the chicken vessels side-to-side anastomosis with 10-0, interrater ICC demonstrated moderate agreement at 0.52 [0.16-0.76]. These results underscore the reliability of MOST. In addition, participant feedback highlighted its ease of use, requiring merely a few minutes to evaluate each end product. CONCLUSION: This study has demonstrated that the MOST is an effective, objective, and reliable tool for self-evaluation in microvascular anastomosis training, demonstrating high levels of agreement across most exercises and offering a user-friendly experience for trainees. This underscores its suitability as a valuable resource for enabling self-driven microvascular anastomosis training and assessment, especially in places where expert evaluation is unavailable.