Abstract
Background
The ability to learn arthroscopic surgery is an important aspect of modern day orthopaedic surgery. Knowing that variation in innate ability exists amongst medical students, the aim of this study was to investigate the effect of training on the arthroscopic surgical performance of our future orthopaedic surgeons (medical students).
Methods
Two arthroscopic tasks (one shoulder and one knee) were set up in a bioskills laboratory to represent core skills required for arthroscopic training. Thirty three medical students with no previous arthroscopic surgery experience were randomised to a ‘Trained’ (n=16) and ‘Non-trained’ (n=17) cohort. Both groups watched an instructional video. The Trained cohort also received specific training on the tasks prior to their first episode. Thirty episodes of each task were then undertaken. 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
During the shoulder task, one subject in the Trained cohort failed to achieve competence compared with six subjects in the Non-trained cohort. During the knee task, two subjects in each cohort failed to achieve competence. Performance of the subjects in the Trained cohort during the shoulder task was significantly better (p<0.05, Chi-squared test). Based on the objective motion analysis parameters, the Trained cohort performed better than the Non-trained cohort for both tasks. This was statistically significant (p<0.05, Mann-Whitney U test) for the shoulder task.
Conclusion
As expected, specific training can improve the arthroscopic performance of novices. There were, however, individuals who could not achieve competency in basic arthroscopic tasks even with focused training. Such assessments might influence students' future career choices.
