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Assessing Diagnostic Arthroscopy Performance in the Operating Room Using the Arthroscopic Surgery Skill Evaluation
Ryan J Koehler1, John P Goldblatt2, Michael D Maloney2
1Department of Orthopaedic Surgery, Vanderbilt Orthopaedic Institute, Vanderbilt University, Nashville, Tennessee, U.S.A..
Summary
The Arthroscopic Surgery Skill Evaluation Tool (ASSET) reliably and validly assesses arthroscopic surgical skills in the operating room. This tool is feasible for evaluating both shoulder and knee arthroscopy proficiency.
Area of Science:
- Orthopaedic Surgery
- Surgical Education
- Medical Simulation
Background:
- Assessing surgical competency is crucial for patient safety and effective training.
- Standardized tools are needed to objectively evaluate arthroscopic surgical skills.
- The Arthroscopic Surgery Skill Evaluation Tool (ASSET) has potential for skill assessment.
Purpose of the Study:
- To determine the validity and reliability of the Arthroscopic Surgery Skill Evaluation Tool (ASSET).
- To assess arthroscopic skill in an operating room setting.
Main Methods:
- Eight orthopaedic residents, one sports medicine fellow, and three faculty members recorded 3 shoulder and 3 knee arthroscopic procedures.
- Two blinded raters evaluated the recorded procedure videos using the ASSET.
- A passing score required a minimum of 3 in all 8 assessed domains.
Main Results:
- Raters demonstrated high agreement on total ASSET scores for shoulder (ICC=0.84) and knee (ICC=0.81) arthroscopy.
- Moderate agreement was found for individual ASSET domains (ICC=0.61-0.80), excluding safety and difficulty.
- Attending/fellow groups scored significantly higher than resident groups (P=.01), with a 95.8% passing rate.
Conclusions:
- The ASSET is a feasible, reliable, and valid tool for assessing arthroscopic surgical skills in the operating room.
- Combined with prior research, the ASSET offers a validated method for evaluating skills in both simulation labs and operating rooms.
