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Assessment of Basic Orthopedic Surgical Skills in a Low-Cost Simulation-Based Setting: A Validation Study
Jacob J Schmidt1, Anders B Nielsen, Thomas B Christensen
1From the Department of Orthopaedic Surgery and Traumatology (J.J.S., B.V.), Odense University Hospital, Odense, Denmark; Research Unit of Medical Education (J.J.S., A.B.N., T.B.C., M.K.), Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Anesthesiology and Intensive Care (A.B.N.), Odense University Hospital, Svendborg, Denmark; Department of Clinical Research (B.V.), University of Southern Denmark, Odense, Denmark; Copenhagen Academy for Medical Education and Simulation (A.G.), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; and Department of Clinical Medicine (A.G.), University of Copenhagen, Copenhagen, Denmark.
This study developed a low-cost simulation test to evaluate basic orthopedic surgery skills (BOSS) in residents. The validated test establishes a mastery standard, enabling objective assessment for surgical training.
Area of Science:
- Orthopedic Surgery
- Medical Simulation
- Surgical Education
Background:
- Basic orthopedic surgery skills (BOSS) are crucial for resident training.
- High costs and limited evidence impede simulation integration into surgical curricula.
- This study addresses the need for valid, low-cost simulation-based assessment of BOSS.
Purpose of the Study:
- To gather validity evidence for a low-cost simulation-based test assessing BOSS.
- To establish a credible mastery standard for objective evaluation of surgical skills.
Main Methods:
- Modified 5 practical BOSS stations using affordable materials and 3D prints.
- Applied the Messick framework for validity evidence collection.
- Compared novice and expert performance using statistical tests to define a mastery standard.
Main Results:
- The simulation test cost less than 900 USD and demonstrated moderate to high reliability (ICC 0.40-0.95).
- Experts significantly outperformed novices (P < 0.022).
- A second novice group achieved mastery after a median of 53.5 attempts.
Conclusions:
- A low-cost, practical test for assessing BOSS has been validated.
- The established mastery standard allows for evidence-based, objective assessment of basic orthopedic surgery skills.
