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.

Purpose: The development of confidence in the operating room is a major goal of surgical training. Confidence in surgery involves trusting information, intuition and experience. Confidence can also be detrimental when it impedes the ability to self-assess skills and decision-making. The measurement of confidence is difficult owing to the sequential acquisition of information and experience. The following study examines the trends in self-reported confidence in residents participating in cadaveric arthroscopic courses.

Method: In 2007 and 2008 residents participating in annual arthroscopic courses at the returned pre-course and post-course questionnaires recording previous arthroscopic exposure. Participants had access to fresh-frozen cadaver specimens and arthroscopic instruments for five hours after didactic lectures. Each participant rated perceived confidence and skill on a five-point Likert scale before and after the course. Mean confidence was compared using a student’s t-test. Data were further analysed using linear regression of pre – and post-course Likert scores.

Results: Residents showed a significant increase in self-perceived confidence in the performance of meniscal repair, anterior cruciate ligament reconstruction and labral repair and subacromial decompression directly after an arthroscopy course (p< 0.01). Regression analysis yielded a y-intercept not significantly different from zero prior to the course with a significant increase in the intercept after the course. There was no significant difference in the relationship of increasing arthroscopic experience to training noted as a result of the course.

Conclusion: Novice residents appeared to gain more self-reported confidence than experienced residents following an arthroscopic skills course. Future courses should consider the separation of novice and experienced residents to focus on improving the self-perceived confidence of experienced residents while exposing novice residents to the complexities of arthroscopic techniques. More research is needed to increase the understanding of the effects of confidence on trainees at various stages of training.