Objective Fluoroscopic Image-Based Assessment of Intraoperative Wire Navigation Skill Agrees with Subjective Expert...

Area of Science:

• Orthopedic Surgery
• Medical Education
• Surgical Skills Assessment

Background:

• Current orthopedic technical skill assessment relies on subjective expert evaluations.
• This study introduces fluoroscopic image-based analysis as an objective assessment tool.
• It compares this objective method to subjective expert opinion for wire navigation procedures.

Purpose of the Study:

• To demonstrate the utility of fluoroscopic image-based analysis for objective assessment of orthopedic technical proficiency.
• To compare objective rankings derived from fluoroscopic analysis with subjective expert consensus.
• To evaluate the reliability and agreement of objective versus subjective skill assessment methods.

Main Methods:

• Fluoroscopic images from 23 pediatric supracondylar humerus fracture pinning procedures were analyzed to create an objective ranking.
• Six experts provided individual rankings, which were aggregated into a consensus ranking.
• Inter-rater reliability (Cronbach's α) and correlation coefficients (Spearman) were calculated to compare rankings.

Main Results:

• Expert assessments showed acceptable inter-rater reliability (α = 0.78).
• A strong agreement was found between the objective ranking and expert consensus (R² = 0.59).
• The objective ranking's agreement with consensus surpassed most individual expert rankings.

Conclusions:

• Objective fluoroscopic image-based analysis is an effective tool for assessing technical operating room performance.
• This objective method can serve as a valuable complementary tool to expert assessment in orthopedic skills training.
• Integrating objective metrics with expert consensus enhances the robustness and scalability of surgical skill assessment.