the Dutch Surgical curriculum. A PBA for the sleeve gastrectomy will be created in future research. Although this study focusses on the technical aspects and training of the LRYGB, the training of residents and fellows should include knowledge of the pathophysiological aspects of obesity, care pathways and treatment plans in metabolic bariatric surgery. These nontechnical skills are a considerable part of the Dutch Surgical curriculum. In conclusion, the procedure-based assessment LRYGB is a novel tool in the arsenal of formative and summative assessment in surgical training. As this PBA LRYGB uses an independence scale instead of specified scoring criteria for each step, it is easily readable and has an administrative load comparable to the OSATS. This study shows this assessment can differentiate between three proficiency levels, taking three videorecorded steps into account. In using predefined key steps and proficiency levels it may be easier to use and less technique depended. We propose to use a PBA as an add-on to the use of global rating scales. While many assessments are valid for formative feedback, only a few have shown to be valid in summative scoring or credentialing. Further research should show if this new PBA LRYGB is valid in summative feedback. Note This chapter was updated to adhere to the 2024 IFSO Accepted Definitions for Publication and to enhance uniformity throughout this thesis. This research was originally published as: Kaijser MA, van Ramshorst GH, van Wagensveld BA, Veeger NJGM, Pierie JEN; Expert panel of Dutch and Belgian Bariatric Surgeons. A New Procedure-Based Assessment of Operative Skills in Gastric Bypass Surgery, Evaluated by Video Fragment Rating. Obes Surg. 2024;34(4):1113-1121. 5 95 A new procedure-based assessment in gastric bypass surgery
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