ABSTRACT
This chapter describes the evolution of Procedure Based Assessments (PBA) from instigation to practical usage and evaluation of the outcome in terms of the instrument and its use. PBAs have been developed against the background of sudden and discontinuous change with reduced access to surgical experience necessitating the introduction of training tools that help to derive maximum benefit from the time available. A PBA happens in real time, in a real operating theatre with a live patient. The potential of the approach went unrecognized until 2002 when the recommendations of the Joint Committee for Higher Surgical Training Competence Working Party made it possible to proceed with PBA development in orthopaedics, at which time it was referred to as a performance-based assessment. In 2008, PBAs are in use in all UK surgical specialties, embedded in all surgical curricula as the primary tool for evaluating perioperative competence in the middle and later years of surgical training.
