Charting the future of competency-based surgical education: a systematic review of cumulative sum

There is broad interest in the education community to shift surgical training from volume-based competency-based benchmarks. Cumulative sum (CUSUM) a method for tracking performance and identifying trainee proficiency that may prove useful facilitating training. The purpose of this study review CUSUM literature to: (1) provide an overview implementation, (2) examine capacity identify learning variations gaps. A systematic search PubMed, Embase, Google Scholar databases was performed studies used track evaluate within general surgery subspecialties. Forty-two articles published between 1995 2021 met criteria. increase annual number CUSUM-related publications over time. Most were related surgery. Both in-vivo simulation tasks well-represented. 71% identified variability among participants, 43% reported at least one participant who failed achieve during period. charts can be variability, development, need intervention all levels. Formal implementation contribute curricula.