The challenge of objective assessment of surgical skill

Although the development of adequate objective measures was initially seen as the most difficult aspect of assessing surgical competence, we now have several useful techniques at our disposal, with clear insights into how and where we should concentrate our efforts to develop further assessments. As we begin to think about the implementation of these measures, it becomes clear that the major challenges from this point on will be philosophical and will relate to the proper and effective use of the tools we have at hand. We have presented our thoughts here, and invite comments from the profession.