Head-camera video recordings of trauma core competency procedures can evaluate surgical resident's technical performance as well as co-located evaluators.

Background: Unbiased evaluation of trauma core competency procedures is necessary to determine if residency and pre-deployment training courses are useful. We tested whether a previously validated Individual Procedure Score (IPS) for individual procedure vascular exposure and fasciotomy (FAS) performance skills, could discriminate training status, by comparing IPS of evaluators co-located with surgeons to blind video evaluations. Methods: Performance of axillary (AA), brachial (BA) and femoral artery (FA) vascular exposures and lower extremity FAS on fresh cadavers by 40 PGY 2-6 residents was video recorded from head- mounted cameras. Two co-located trained evaluators assessed IPS before and after training. One surgeon in each pre-training tertile of IPS for each procedure was randomly identified for blind video review. The same 12 surgeons were video-recorded repeating the procedures =0.5) in IPS for AA, FA, FAS whether evaluators were co-located or reviewed video -recordings. Evaluator consistency was 0.29 (BA)- 0.77 (FA). Video and co-located evaluators were in total agreement (p =1.0) for error recognition. ICC was 0.73-0.92, dependent on procedure. Correlations video versus co-located evaluations were 0.5-0.9. Except for BA, blinded video evaluators discriminated (p

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