Journal of Surgical Simulation 2019; 6: 31 - 38

Published: 19 August 2019


Original article

A literature review of educational feedback in the operating room: plastic surgery residents’ perception of feedback from the O-SCORE

Yaeesh Sardiwalla, Nadim Joukhadar and David Tang
Corresponding author: Yaeesh Sardiwalla, Clinical Research Center – Room C125, 5849 University Avenue, Halifax, B3H 4R2, Canada. Email:


Introduction: Surgical teaching in the operating room represents a unique and distinct aspect of medical education. Traditionally, an apprenticeship model of learning and feedback has been used. Recent changes in residency education have demanded a reevaluation of this model, resulting in the pursuit of improving educational feedback in the operating room through structured feedback. The Ottawa Surgical Competency Operating Room Evaluation (O-SCORE) evaluates surgical skills and was recently introduced to the Plastic Surgery Training Program in addition to the traditional In-Training Evaluation Report (ITER).

Methods: Plastic surgery residents (postgraduate years 2–5, N = 9) who were exposed to the transition between using ITER and O-SCORE evaluations were recruited. A grounded theory approach was used to analyze a semi-structured focus group with the residents. In addition, a 5-minute survey contrasting ITER
and O-SCORE methods was distributed.

Results: Residents suggested the O-SCORE has led to more opportune feedback, more comprehensive discussion of surgical procedures, and improved progress tracking compared with traditional methods. Although there is a role for reactionary feedback, residents unanimously agreed that the OSCORE heralded an improvement in their learning.

Conclusion: The introduction of the O-SCORE to the Plastic  Surgery Program has complemented traditional feedback. Even though the O-SCORE adds to the evaluation burden, it may have an important role in the assessment structure of surgical residency training programs.


medical education; plastic surgery; teaching; O-SCORE; ITER; feedback