Original Research Article| Volume 223, ISSUE 5, P905-911, May 2022

Mastery skill assessment in hepato-pancreato-biliary surgical ultrasound: It's a Matter of Entrustment


      • HPB Fellows are assessed during an annual skills practicum in HPB US.
      • Assessment tools for open and laparoscopic HPB US have been developed.
      • A panel of expert faculty established Mastery Entrustment standards.
      • Entrustment standards were applied to a sample of HPB surgery fellows.
      • A sample of graduating HPB fellows did not meet entrustment standards for HPB US.



      A formative hepato-pancreato-biliary (HPB) ultrasound (US) skills practicum is offered annually to graduating HPB fellows, using entrustment assessments for open (IOUS) and laparoscopic (LAPUS) US. It is hypothesized that validity evidence will support the use of these assessments to determine if graduating fellows are well prepared to perform HPB US independently.


      Expert faculty were surveyed to set Mastery Entrustment standards for fellow performance. Standards were applied to fellow performances during two annual US skills practicums.


      11 faculty questionnaires were included. Mean Entrustment cut scores across all items were 4.9/5.0 and 4.8/5.0 and Global Entrustment cut scores were 5.0/5.0 and 4.8/5.0 for IOUS and LAPUS, respectively. 78.5% (29/37) fellows agreed to have their de-identified data evaluated. Mean fellow Entrustments (across all skills) were 4.1 (SD 0.6; 2.6–4.9) and 3.9 (SD 0.7; 2.7–5), while the Global Entrustments were 3.6 (SD 0.8; 2–5) and 3.5 (SD 1.0; 2–5) for IOUS and LAPUS, respectively.


      Two cohorts of graduating HPB fellows are not meeting Mastery Standards for HPB US performance determined by a panel of expert faculty.


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