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Arthroscopic proficiency: methods in evaluating competency.

Hodgins JL, Veillette C - BMC Med Educ (2013)

Bottom Line: Instrument and force trajectory data can discriminate between technical ability for basic arthroscopic parameters and may serve as useful adjuncts to more comprehensive techniques.Opinion on the required arthroscopic experience to obtain proficiency remains guarded and few governing bodies specify absolute quantities.Further validation is required to demonstrate the transfer of complex arthroscopic skills from simulated environments to the operating room and provide objective parameters to base evaluation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Orthopaedics, Toronto Western Hospital, Toronto, Canada. justin.hodgins@mail.utoronto.ca

ABSTRACT

Background: The current paradigm of arthroscopic training lacks objective evaluation of technical ability and its adequacy is concerning given the accelerating complexity of the field. To combat insufficiencies, emphasis is shifting towards skill acquisition outside the operating room and sophisticated assessment tools. We reviewed (1) the validity of cadaver and surgical simulation in arthroscopic training, (2) the role of psychomotor analysis and arthroscopic technical ability, (3) what validated assessment tools are available to evaluate technical competency, and (4) the quantification of arthroscopic proficiency.

Methods: The Medline and Embase databases were searched for published articles in the English literature pertaining to arthroscopic competence, arthroscopic assessment and evaluation and objective measures of arthroscopic technical skill. Abstracts were independently evaluated and exclusion criteria included articles outside the scope of knee and shoulder arthroscopy as well as original articles about specific therapies, outcomes and diagnoses leaving 52 articles cited in this review.

Results: Simulated arthroscopic environments exhibit high levels of internal validity and consistency for simple arthroscopic tasks, however the ability to transfer complex skills to the operating room has not yet been established. Instrument and force trajectory data can discriminate between technical ability for basic arthroscopic parameters and may serve as useful adjuncts to more comprehensive techniques. There is a need for arthroscopic assessment tools for standardized evaluation and objective feedback of technical skills, yet few comprehensive instruments exist, especially for the shoulder. Opinion on the required arthroscopic experience to obtain proficiency remains guarded and few governing bodies specify absolute quantities.

Conclusions: Further validation is required to demonstrate the transfer of complex arthroscopic skills from simulated environments to the operating room and provide objective parameters to base evaluation. There is a deficiency of validated assessment tools for technical competencies and little consensus of what constitutes a sufficient case volume within the arthroscopy community.

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EMBASE database search results (12 of 104 studies included).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
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Figure 2: EMBASE database search results (12 of 104 studies included).

Mentions: A comprehensive search of the Ovid MedLine (Figure 1) and EMBASE (Figure 2) databases published in the English literature was performed. Search terms were altered for each database according to its method of subheading mapping. The search results and number of studies found at each stage are listed below:


Arthroscopic proficiency: methods in evaluating competency.

Hodgins JL, Veillette C - BMC Med Educ (2013)

EMBASE database search results (12 of 104 studies included).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643847&req=5

Figure 2: EMBASE database search results (12 of 104 studies included).
Mentions: A comprehensive search of the Ovid MedLine (Figure 1) and EMBASE (Figure 2) databases published in the English literature was performed. Search terms were altered for each database according to its method of subheading mapping. The search results and number of studies found at each stage are listed below:

Bottom Line: Instrument and force trajectory data can discriminate between technical ability for basic arthroscopic parameters and may serve as useful adjuncts to more comprehensive techniques.Opinion on the required arthroscopic experience to obtain proficiency remains guarded and few governing bodies specify absolute quantities.Further validation is required to demonstrate the transfer of complex arthroscopic skills from simulated environments to the operating room and provide objective parameters to base evaluation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Orthopaedics, Toronto Western Hospital, Toronto, Canada. justin.hodgins@mail.utoronto.ca

ABSTRACT

Background: The current paradigm of arthroscopic training lacks objective evaluation of technical ability and its adequacy is concerning given the accelerating complexity of the field. To combat insufficiencies, emphasis is shifting towards skill acquisition outside the operating room and sophisticated assessment tools. We reviewed (1) the validity of cadaver and surgical simulation in arthroscopic training, (2) the role of psychomotor analysis and arthroscopic technical ability, (3) what validated assessment tools are available to evaluate technical competency, and (4) the quantification of arthroscopic proficiency.

Methods: The Medline and Embase databases were searched for published articles in the English literature pertaining to arthroscopic competence, arthroscopic assessment and evaluation and objective measures of arthroscopic technical skill. Abstracts were independently evaluated and exclusion criteria included articles outside the scope of knee and shoulder arthroscopy as well as original articles about specific therapies, outcomes and diagnoses leaving 52 articles cited in this review.

Results: Simulated arthroscopic environments exhibit high levels of internal validity and consistency for simple arthroscopic tasks, however the ability to transfer complex skills to the operating room has not yet been established. Instrument and force trajectory data can discriminate between technical ability for basic arthroscopic parameters and may serve as useful adjuncts to more comprehensive techniques. There is a need for arthroscopic assessment tools for standardized evaluation and objective feedback of technical skills, yet few comprehensive instruments exist, especially for the shoulder. Opinion on the required arthroscopic experience to obtain proficiency remains guarded and few governing bodies specify absolute quantities.

Conclusions: Further validation is required to demonstrate the transfer of complex arthroscopic skills from simulated environments to the operating room and provide objective parameters to base evaluation. There is a deficiency of validated assessment tools for technical competencies and little consensus of what constitutes a sufficient case volume within the arthroscopy community.

Show MeSH