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Live Observational Objective Assessment of Operative Performance in a Cadaveric Model is Equivalent to Delayed

Richard L Angelo1, Pat St Pierre2, Joe Tauro3

  • 1ProOrtho Clinic Kirkland, Washington, U.S.A..

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|May 8, 2021
PubMed
Summary

Live operative performance scoring is equivalent to delayed video review for assessing arthroscopic Bankart repairs and rotator cuff repairs. Both methods reliably measure surgical skill attainment and proficiency benchmarks.

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Area of Science:

  • Orthopedic Surgery
  • Surgical Education
  • Medical Simulation

Background:

  • Proficiency-based progression curricula are increasingly used in surgical training.
  • Objective assessment of operative performance is crucial for skill development.
  • Comparing live observation with video review is essential for validating assessment methods.

Purpose of the Study:

  • To compare real-time, live observational scoring with delayed retrospective video review of operative performance.
  • To determine if the evaluation method impacts the attainment of proficiency benchmarks in arthroscopic Bankart repairs (ABRs) and arthroscopic rotator cuff repairs (ARCRs).

Main Methods:

  • Sixteen fellows and 2 residents performed ABRs and ARCRs, with final operative performances scored live and via delayed video review.
  • Validated metric-based (step and error) assessment tools were used by trained raters.
  • Inter-rater reliability (IRR) and correlation coefficients (r, R² ) were calculated to compare scoring methods.

Main Results:

  • No significant differences in IRR agreement or proficiency benchmark attainment were found between live and video assessments for ABRs and ARCRs.
  • Correlation coefficients (r, R²) were consistently lower than IRR agreement coefficients, indicating greater homogeneity and precision with IRR.
  • Specific examples show R² values significantly lower than IRR for rotator cuff steps, Bankart errors, and rotator cuff errors.

Conclusions:

  • Real-time live and delayed video-based scoring are equivalent for metric-based assessment of ABRs and ARCRs.
  • Inter-rater reliability (IRR) offers greater homogeneity and measurement precision compared to correlation coefficients when assessing operative performance.
  • Metric-based live scoring is a reliable and accurate method for operative performance assessment, suitable for high-stakes evaluations.