Development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear: A pilot study
Introduction: As resident evaluation moves to a competency-based system, validated tools for assessment of surgical skill are increasingly important. We created and validated a checklist to measure resident surgical skill for arthroscopic management of meniscal tear. Materials and Methods: Using a D...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Surgery in Practice and Science |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266626202300044X |
| _version_ | 1797690241244463104 |
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| author | Rachel S. Bronheim Majd Marrache Alexander E. Loeb Johnathan A. Bernard Dawn M. LaPorte |
| author_facet | Rachel S. Bronheim Majd Marrache Alexander E. Loeb Johnathan A. Bernard Dawn M. LaPorte |
| author_sort | Rachel S. Bronheim |
| collection | DOAJ |
| description | Introduction: As resident evaluation moves to a competency-based system, validated tools for assessment of surgical skill are increasingly important. We created and validated a checklist to measure resident surgical skill for arthroscopic management of meniscal tear. Materials and Methods: Using a Delphi survey method, we created an objective, structured assessment of surgical skill for treatment of meniscal tears. The Meniscus Treatment Task List (MTTL) comprises 5 domains: diagnostic arthroscopy, medial meniscectomy, lateral meniscectomy, medial meniscal repair, and lateral meniscal repair. Orthopaedic surgery residents were recruited to perform diagnostic arthroscopy, partial meniscectomies, and all-inside meniscal repairs with cadaveric models. Arthroscopic videos were graded by fellowship-trained surgeons using the MTTL and the validated Arthroscopic Surgical Skill Evaluation Tool (ASSET) global rating scale (GRS). Postgraduate year (PGY), operative time, and case logs were recorded for each resident. Data were analysed using bivariate correlation, analysis of variance, pairwise comparison, Pearson's correlation coefficient, and intraclass correlation coefficient. α=0.05. Results: Twenty-two orthopaedic surgery residents (PGY1–PGY4) participated. MTTL scores were higher in the PGY4 class than in the PGY1 class (mean difference, 11 points, p = 0.04). Operative time was inversely correlated with number of cases logged (r = –0.53, p = 0.01), number of arthroscopic cases logged (r = –0.50, p = 0.02), and MTTL score (r = –0.46, p = 0.03). MTTL score was positively correlated with number of cases (r = 0.44, p = 0.04) and number of arthroscopic cases logged (r = 0.50, p = 0.02). MTTL scores were positively correlated with the ASSET GRS (r = 0.71, p<0.001). Intraclass correlation coefficient of 0.89 and Pearson's correlation coefficient of 0.89 demonstrated strong interrater reliability of MTTL scores (p<0.01). Conclusions: This pilot study demonstrates the validity and reliability of the MTTL for assessing resident proficiency in arthroscopic management of meniscal tears in cadaveric specimens. Expansion of this model to other orthopaedic procedures for objective assessment of surgical skill may be useful. |
| first_indexed | 2024-03-12T01:56:43Z |
| format | Article |
| id | doaj.art-f83758ae9b0c4a6898631ee5895d099c |
| institution | Directory Open Access Journal |
| issn | 2666-2620 |
| language | English |
| last_indexed | 2024-03-12T01:56:43Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj.art-f83758ae9b0c4a6898631ee5895d099c2023-09-08T04:33:59ZengElsevierSurgery in Practice and Science2666-26202023-09-0114100198Development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear: A pilot studyRachel S. Bronheim0Majd Marrache1Alexander E. Loeb2Johnathan A. Bernard3Dawn M. LaPorte4Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USAOrthoVirginia, Herndon, VA, USADepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding author at: Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline St., Baltimore, MD 21287, USA.Introduction: As resident evaluation moves to a competency-based system, validated tools for assessment of surgical skill are increasingly important. We created and validated a checklist to measure resident surgical skill for arthroscopic management of meniscal tear. Materials and Methods: Using a Delphi survey method, we created an objective, structured assessment of surgical skill for treatment of meniscal tears. The Meniscus Treatment Task List (MTTL) comprises 5 domains: diagnostic arthroscopy, medial meniscectomy, lateral meniscectomy, medial meniscal repair, and lateral meniscal repair. Orthopaedic surgery residents were recruited to perform diagnostic arthroscopy, partial meniscectomies, and all-inside meniscal repairs with cadaveric models. Arthroscopic videos were graded by fellowship-trained surgeons using the MTTL and the validated Arthroscopic Surgical Skill Evaluation Tool (ASSET) global rating scale (GRS). Postgraduate year (PGY), operative time, and case logs were recorded for each resident. Data were analysed using bivariate correlation, analysis of variance, pairwise comparison, Pearson's correlation coefficient, and intraclass correlation coefficient. α=0.05. Results: Twenty-two orthopaedic surgery residents (PGY1–PGY4) participated. MTTL scores were higher in the PGY4 class than in the PGY1 class (mean difference, 11 points, p = 0.04). Operative time was inversely correlated with number of cases logged (r = –0.53, p = 0.01), number of arthroscopic cases logged (r = –0.50, p = 0.02), and MTTL score (r = –0.46, p = 0.03). MTTL score was positively correlated with number of cases (r = 0.44, p = 0.04) and number of arthroscopic cases logged (r = 0.50, p = 0.02). MTTL scores were positively correlated with the ASSET GRS (r = 0.71, p<0.001). Intraclass correlation coefficient of 0.89 and Pearson's correlation coefficient of 0.89 demonstrated strong interrater reliability of MTTL scores (p<0.01). Conclusions: This pilot study demonstrates the validity and reliability of the MTTL for assessing resident proficiency in arthroscopic management of meniscal tears in cadaveric specimens. Expansion of this model to other orthopaedic procedures for objective assessment of surgical skill may be useful.http://www.sciencedirect.com/science/article/pii/S266626202300044XMeniscus tearResident competencySurgical educationSurgical skill |
| spellingShingle | Rachel S. Bronheim Majd Marrache Alexander E. Loeb Johnathan A. Bernard Dawn M. LaPorte Development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear: A pilot study Surgery in Practice and Science Meniscus tear Resident competency Surgical education Surgical skill |
| title | Development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear: A pilot study |
| title_full | Development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear: A pilot study |
| title_fullStr | Development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear: A pilot study |
| title_full_unstemmed | Development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear: A pilot study |
| title_short | Development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear: A pilot study |
| title_sort | development and validation of an objective assessment of surgical skill in arthroscopic management of meniscal tear a pilot study |
| topic | Meniscus tear Resident competency Surgical education Surgical skill |
| url | http://www.sciencedirect.com/science/article/pii/S266626202300044X |
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