Abstract
Introduction
Restrictions placed on the working hours of doctors have led to increasing time-pressures on surgical training. Consequently, there has been growing interest in developing new techniques to teach and assess technical skills. The primary aim of this study was to determine whether a novel set of visual parameters assessing visuospatial ability, fine motor dexterity and gaze control could objectively distinguish between varying levels of arthroscopic experience. The secondary aim was to evaluate the correlations between these new parameters and previously established technical skill assessment methods.
Methods
27 subjects were divided into a “novice” group (n=7), “trainee” group (n=15) and expert group (n=5) based on previous arthroscopic experience. All subjects performed a diagnostic knee arthroscopy task on a simulator. Their performance was assessed using new simple visual parameters that included “prevalence of instrument loss,” “triangulation time” and “prevalence of look downs”. In addition, performance was also evaluated using previously validated technical skill assessment methods (a global rating scale and motion analysis).
Results
A significant difference in performance between the groups was demonstrated using all three novel visual parameters, the global rating scale and motion analysis (Mann-Whitney U test, p< 0.05). There were strong and highly significant correlations (Spearman's rank correlation coefficient, p< 0.0001) between each of the novel parameters and the previously validated skill assessment methods.
Conclusion
This study demonstrates the construct validity of three novel visual parameters for objectively assessing arthroscopic performance. Two of these are simple, can be used easily in the operating theatre, and are highly correlated with current validated methods of technical skill assessment. Given the paramount importance of identifying objective methods for evaluating technical skill in arthroscopic surgery, the generic nature of these simple visual parameters make them a powerful and user-friendly objective assessment tool, which may offer an alternative to existing assessment methods.
