The development of an objective model to assess arthroscopic performance

Area of Science:

• Orthopedic Surgery
• Medical Education
• Surgical Skills Assessment

Background:

• Cadaver laboratories are crucial for teaching arthroscopic skills in residency and fellowship programs.
• Currently, there is a lack of validated methods to objectively assess arthroscopic proficiency in these settings.
• This study addresses the need for a reliable evaluation tool in bioskills laboratory training.

Purpose of the Study:

• To develop and validate an objective model for assessing basic arthroscopic proficiency on a cadaver knee.
• To create a standardized scoring system for surgical skill evaluation.
• To establish benchmarks for arthroscopic competency in surgical training.

Main Methods:

• Adapted educational measures: a task-specific checklist and a global rating scale, combined into the Basic Arthroscopic Knee Skill Scoring System (BAKSSS).
• Recruited 59 residents, 3 fellows, and 6 attending surgeons for the study.
• Participants performed a diagnostic knee arthroscopy and partial meniscectomy on a cadaver knee, assessed by a single evaluator using the BAKSSS.

Main Results:

• Global rating scale scores strongly correlated with postgraduate year (r=0.93) and arthroscopy experience (r=0.88), showing significant differences between training levels.
• Task-specific checklist scores moderately correlated with postgraduate year (r=0.73) and experience (r=0.64).
• The BAKSSS identified significant skill differences between early postgraduate years, indicating rapid skill acquisition.

Conclusions:

• The Basic Arthroscopic Knee Skill Scoring System effectively captures and differentiates arthroscopic skill levels.
• This validated model objectively assesses basic arthroscopic proficiency in a bioskills laboratory setting.
• The system enables the creation of training benchmarks and monitoring of individual surgical skill progression.