A surgical skills assessment rubric for pterygium surgery

Mehran Zarei-Ghanavati, Hamed Ghassemi, Mirataollah Salabati, Raziyeh Mahmoudzadeh, Christopher Liu, Mark Daniell, Andrew J.W. Huang, Ahmad Kheirkhah, Ali R. Djalilian

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Purpose: To introduce an assessment tool (rubric) for evaluating ophthalmology residents’ competency in pterygium surgery. Methods: A panel of experienced international surgeons collaborated and developed the rubric. After describing various stages of the procedure, the Dreyfus scale of skill acquisition was used for scoring each stage. After finalizing the rubric, two surgeons independently evaluated 20 masked pterygium surgery videos of 10 residents and scored the videos according to the rubric. The agreement between the scores of them was examined with the intra-class correlation coefficient test. Results: This rubric divides pterygium surgery into 13 different stages and covers the two most common techniques of pterygium surgery; conjunctival autograft and amniotic membrane transplant. The rubric showed face and content validity. Overall, an intraclass correlation coefficient of 0.90 (95% confidence interval 0.76–0.96, P < 0.001) was achieved between the two surgeons. The residents scored significantly higher on surgeries performed later in their rotation compared to the earlier surgeries (4.32 ± 0.35 vs 3.96 ± 0.31, P = 0.006). Certain stages of pterygium surgery were more strongly correlated with the residents’ past pterygium surgical experience. Conclusion: This study introduces an international rubric for assessing competency in pterygium surgery. In addition to face and content validity, this rubric shows high inter-rater reliability. This may be a useful tool for teaching and measuring competency in pterygium surgery.

Original languageEnglish (US)
Pages (from-to)494-498
Number of pages5
JournalOcular Surface
Issue number3
StatePublished - Jul 2020


  • Pterygium surgery
  • Rubric
  • Surgical skill assessment

ASJC Scopus subject areas

  • Ophthalmology


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