OpTrust: Validity of a Tool Assessing Intraoperative Entrustment Behaviors

Gurjit Sandhu, Vahagn C. Nikolian, Christopher P. Magas, Robert B. Stansfield, Danielle C. Sutzko, Kaustubh Prabhu, Niki Matusko, Rebecca M. Minter

Research output: Contribution to journalArticle

11 Scopus citations


OBJECTIVE:: The aim of this study is to establish evidence to support the validity of a novel faculty-resident intraoperative assessment tool for entrustment known as OpTrust. BACKGROUND:: Recently, the landscape of surgical training has been altered, in part, because of resident work-hour changes and increased supervision requirements. To address these concerns, a new model for assessment of teaching and learning in surgical residencies must be anchored on progression through milestones and entrustment. METHODS:: OpTrust was designed to assess the faculty-resident dyad in the operating room and measure the entrustment exhibited during intraoperative interactions across 5 domains: (i) types of questions asked, (ii) operative plan, (iii) instruction, (iv) problem solving, and (v) leadership by the surgical resident. After initial pilot testing and refinement of OpTrust, 5 individual raters underwent rater training sessions; 49 individual operating room observations were completed based on 28 cases. RESULTS:: OpTrust, as a tool for assessing intraoperative entrustment, is supported by strong validity evidence. In part, it demonstrates strong interrater reliability across all faculty domains as measured by intraclass correlation 1 (ICC1) (0.81–0.93). For resident domains the results were similar with ICC1 (0.84–0.94). Cronbach alpha was 0.89 and 0.87 for faculty and resident entrustment respectively, signifying the 5 domains could be combined into a single construct of entrustment. A high correlation existed between faculty and resident scores (Pearson r = 0.94, P < 0.001) indicating a strong positive linear relationship between faculty and resident mean entrustment scores across all scale domains. CONCLUSIONS:: OpTrust successfully assesses behaviors associated with entrustment during intraoperative faculty-resident interactions, and has the potential to be adopted across other procedural-based specialties to promote autonomous training progression.

Original languageEnglish (US)
JournalAnnals of Surgery
StateAccepted/In press - Mar 27 2017

ASJC Scopus subject areas

  • Surgery

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    Sandhu, G., Nikolian, V. C., Magas, C. P., Stansfield, R. B., Sutzko, D. C., Prabhu, K., Matusko, N., & Minter, R. M. (Accepted/In press). OpTrust: Validity of a Tool Assessing Intraoperative Entrustment Behaviors. Annals of Surgery. https://doi.org/10.1097/SLA.0000000000002235