OpTrust Assessment

What does entrustment look like at your institution?

Faculty entrustment and resident entrustability can be measured with the OpTrust entrustment measurement tool. OpTrust is a validated intraoperative entrustment measurement tool which enables trained third-party raters to objectively score faculty entrustment and resident entrustability during intraoperative educational interactions.

How does OpTrust measure entrustment and entrustability?

OpTrust independently measures faculty entrustment and resident entrustability through the observation, recording, and scoring of five behavioral domains during the intraopertive educational interaction:

These domains are scored on a scale of 1 – 4; a score of 1 indicates low entrustment or entrustability, while a score of 4 signifies full entrustment or entrustability.

Surgical cases are rated for 1-hour from first incision. Assessment of entrustment behaviors using this short-course review have been shown to be feasible for intraoperative entrustment assessment and allows for the tool to be incorporated into surgical training programs across a variety of environments.

The tool provides a global overview of faculty entrustment and resident entrustability, as well as granular measures of each of the 5 contributing domains.

The OpTrust tool is organized into 5 horizontal columns, each representing a behavioral domain: types of questions asked, operative plan, instruction, problem solving, and leadership by the surgical resident. Each domain is divided into 2 sections. The shaded section delineates faculty behaviors which are separated into four vertical columns representing levels of entrustment: low, medium, high, and full. The unshaded section specifies resident behaviors which are also separated into four vertical columns representing levels of entrustability: low, medium, high, and full.

Training OpTrust Raters at your Institution

An OpTrust rater training webinar has been developed to provide standardized training on the use of the OpTrust measurement tool. This webinar consists of a 2-hour session that introduces trainees to surgical education, intraoperative interactions, educational domains, entrustment behaviors, and verbal/nonverbal communication styles. Next, trainees must shadow a surgical education expert for 2-3 in-person cases, or until their OpTrust scores reach 80% inter-rater reliability with the expert. We have successfully trained raters with both surgical and non-surgical backgrounds. Previous raters have come from a variety of backgrounds, including:

• faculty surgeons
• surgery residents (on academic development time)
• researchers
• research assistants
• medical students
• pre-med honors students
• post-baccalaureate students