Assessment of Surgical Skills in Implant Dentistry

Purpose: This study aimed to (1) compare 2 scales in the assessment of first-stage implant surgery, (2) assess the interrater reliability of these scales, and (3) compare self-assessment with observer assessment. Materials and Methods: Twenty-three patients underwent first-stage implant surgery. One assessor, an experienced dental surgeon, assisted and supervised the operator, while the second, a postgraduate trained in assessment, observed the procedure closely. The assessment scales consisted of a checklist and a global rating scale. Results: A significant correlation was found between the checklist and the global rating scale scores (r = 0.47, P = .002). The British Standards Reproducibility Coefficients were 2.5 (checklist) and 7.4 (global rating scale) for interrater reproducibility and 7.0 (checklist) and 12.6 (global rating scale) for self-assessment versus assessor reproducibility. Finally, analysis of the intraclass correlation coefficients between the assessors (0.74 and 0.64 for the checklist and the global rating scale, respectively) and between the surgeons' and trainers' scores (0.09 for the checklist and 0.18 for the global rating scale) showed a much weaker agreement for the latter. Discussion: There was good correlation between scores using the 2 different methods of assessment. The interrater reliability was substantial for both scales. However, training of assessors to ensure higher levels of interrater reliability may be necessary. These results also demonstrated the inability of some surgeons to assess their performance accurately. Conclusion: Both the checklist and the global rating scales provided useful assessment data, and both were considered of value by the assessors and surgeons in providing feedback. The development of assessment and self-assessment skills in implant surgery is necessary if we are to establish a culture of commitment to lifelong learning.