Abstract
Purpose
The development of skills in arthroscopic surgery is essential to the training of modern orthopedic surgeons. Few validated, objective tools exist which track improvement in arthroscopic skills. The purpose of this study was to validate an objective global assessment of arthroscopic skills employing videotape footage of diagnostic arthroscopy performed by participants of various skill levels on a cadaveric knee.
Method
A total of 22 participants with varying arthroscopic experience performed a recorded diagnostic knee arthroscopy on a cadaveric knee. Recorded footage of the procedures from an arthroscopic and external view was assessed by five blinded evaluators and scored on a global skills evaluation and checklist evaluation form. Interclass correlation coefficient analyses were used to determine the inter-rater reliability. Mean scores of novice and experienced residents and practicing arthroscopists (based on rank and experience) were compared using a students t-test.
Results
Interclass correlation coefficient for the five raters on the global rating scale was 0.626 indicating moderate to good agreement. Interclass correlation coefficient for visual analogue scale skill measurement was 0.645. Discriminant validity was shown by the ability of the global assessment to differentiate novice (95% CI=24-29%) and experienced residents (95% CI=33-59%) from fellows (95% CI=70-87%) and knee arthroscopy staff (95% CI=79-84%). There was a ceiling effect based on the inability to differentiate fellows from knee arthroscopy staff.
Conclusion
The Objected Assessment of Arthroscopic Skills global rating scale is a valid, reliable measure of arthroscopic skills in residents. It could be used for evaluative or educational purposes in orthopedic training. The method of blinded evaluation of participants provides a feasible method for the evaluation of resident arthroscopic skills with limited bias which could be implemented in training programs.
