Abstract
Background
Technical skill is an essential domain of surgical competency. Arthroscopic surgery forms a particularly challenging subset of these skills. The innate ability to acquire these skills is not fully understood. The aim of this study was to investigate the innate arthroscopic skills and learning curve patterns of medical students - our future surgeons.
Methods
Two arthroscopic tasks (one shoulder and one knee) were set up in a bioskills laboratory to represent core skills required for arthroscopic training. Twenty medical students with no previous arthroscopic surgery experience were recruited and their performance assessed whilst undertaking each task on 30 occasions. The primary outcome variable was success or failure. Individuals were assessed as ‘competent’ if they stabilised their learning curve within 20 episodes. The secondary outcome measure was an objective assessment of technical dexterity using a validated Motion Analysis system (time taken to complete tasks, total path length of the subject's hands, and number of hand movements).
Results
There was variability in the performance of the students. Seven students in the shoulder task and four students in the knee task were unable to achieve competence. Motion analysis data demonstrated that students who achieved task competence had better objective technical dexterity and therefore better innate arthroscopic ability. For the shoulder task, these differences were statistically significant for ‘path length’ and ‘hand movement’ (p<0.05, Mann-Whitney U test). For the knee task, the differences were statistically significant for ‘path length’ (P<0.05, Mann-Whitney U test).
Conclusion
Variation in innate arthroscopic skill exists in our future surgeons with some individuals being unable to achieve competence at basic arthroscopic tasks despite sustained practice. It may be of great value to identify individuals who lack innate arthroscopic skills early in their career in order to provide them with focused training and relevant career guidance.
