{"doi":"10.1002/lary.31391","title":"Correcting for Rater Effects in Operating Room Surgical Skills Assessment","abstract":"OBJECTIVE: To estimate and adjust for rater effects in operating room surgical skills assessment performed using a structured rating scale for nasal septoplasty. METHODS: We analyzed survey responses from attending surgeons (raters) who supervised residents and fellows (trainees) performing nasal septoplasty in a prospective cohort study. We fit a structural equation model with the rubric item scores regressed on a latent component of skill and then fit a second model including the rating surgeon as a random effect to model a rater-effects-adjusted latent surgical skill. We validated this model against conventional measures including the level of expertise and post-graduation year (PGY) commensurate with the trainee's performance, the actual PGY of the trainee, and whether the surgical goals were achieved. RESULTS: Our dataset included 188 assessments by 7 raters and 41 trainees. The model with one latent construct for surgical skill and the rater as a random effect was the best. Rubric scores depended on how severe or lenient the rater was, sometimes almost as much as they depended on trainee skill. Rater-adjusted latent skill scores increased with attending-estimated skill levels and PGY of trainees, increased with the actual PGY, and appeared constant over different levels of achievement of surgical goals. CONCLUSION: Our work provides a method to obtain rater effect adjusted surgical skill assessments in the operating room using structured rating scales. Our method allows for the creation of standardized (i.e., rater-effects-adjusted) quantitative surgical skill benchmarks using national-level databases on trainee assessments. LEVEL OF EVIDENCE: N/A Laryngoscope, 134:3548-3554, 2024.","journal":"The Laryngoscope","year":2024,"id":452162,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9445,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":832426,"name":"Hajira Naz","orcid":null,"position":1,"is_corresponding":false},{"id":1273990,"name":"Kofi Boahene","orcid":"0000-0002-4924-7560","position":2,"is_corresponding":false},{"id":544280,"name":"Jessica H. Maxwell","orcid":"0000-0002-5935-0887","position":3,"is_corresponding":false},{"id":1274450,"name":"John R. Wanamaker","orcid":null,"position":4,"is_corresponding":false},{"id":307201,"name":"Patrick J. Byrne","orcid":"0000-0003-2569-6019","position":5,"is_corresponding":false},{"id":1274451,"name":"Ira D. Papel","orcid":null,"position":6,"is_corresponding":false},{"id":1274452,"name":"Theda C. Kontis","orcid":null,"position":7,"is_corresponding":false},{"id":552238,"name":"Gregory D. Hager","orcid":"0000-0002-6662-9763","position":8,"is_corresponding":false},{"id":799286,"name":"Lisa E. Ishii","orcid":"0000-0001-5287-2597","position":9,"is_corresponding":false},{"id":1273991,"name":"Sonya Malekzadeh","orcid":"0000-0002-1631-4392","position":10,"is_corresponding":false},{"id":684746,"name":"S. Swaroop Vedula","orcid":"0000-0002-6992-2957","position":11,"is_corresponding":false},{"id":499125,"name":"Masaru Ishii","orcid":"0000-0002-4215-007X","position":12,"is_corresponding":false},{"id":1273989,"name":"Ryan Chou","orcid":"0009-0000-8520-0404","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-19T02:02:50.407779Z","pmid":"38470307","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}