The number of arthroscopies performed by trainees does not deduce the level of their arthroscopic proficiency

Author:

Anetzberger Hermann1ORCID,Kugler Andreas2,John Dominik3,Kopf Sebastian4,Becker Roland4,Reppenhagen Stephan5

Affiliation:

1. Orthopädische Gemeinschaftspraxis am OEZ Hanauer Str. 65 80993 Munich Germany

2. Zentrum für Gelenkchirurgie im MVZ am Nordbad Schleißheimer Straße 130 80797 Munich Germany

3. Gelenk.Bonn Bonner Talweg 61 53113 Bonn Germany

4. Zentrum für Orthopädie und Unfallchirurgie Universitätsklinikum Brandenburg der Medizinischen Hochschule Brandenburg Theodor Fontane Hochstraße 29 14770 Brandenburg an der Havel Germany

5. Orthopädische Klinik König‐Ludwig‐Haus Brettreichstraße 11 97074 Würzburg Germany

Abstract

AbstractPurposeIt is reasonable to question whether the case volume is a suitable proxy for the manual competence of an arthroscopic surgeon. The aim of this study was to evaluate the correlation between the number of arthroscopies previously performed and the arthroscopic skills acquired using a standardized simulator test.MethodsA total of 97 resident and early orthopaedic surgeons who participated in arthroscopic simulator training courses were divided into five groups based on their self‐reported number of arthroscopic surgeries: (1) none, (2) < 10, (3) 10 to 19, (4) 20 to 39 and (5) 40 to 100. Arthroscopic manual skills were evaluated with a simulator by means of the diagnostic arthroscopy skill score (DASS) before and after training. Seventy‐five points out of 100 must be achieved to pass the test.ResultsIn the pretest, only three trainees in group 5 passed the arthroscopic skill test, and all other participants failed. Group 5 (57 ± 17 points; n = 17) scored significantly higher than the other groups (group 1: 30 ± 14, n = 20; group 2: 35 ± 14, n = 24; group 3: 35 ± 18, n = 23; and group 4: 33 ± 17, n = 13). After a two‐day simulator training, trainees showed a significant increase in performance. In group 5, participants scored 81 ± 17 points, which was significantly higher than the other groups (group 1: 75 ± 16; group 2: 75 ± 14; group 3: 69 ± 15; and group 4: 73 ± 13). While self‐reported arthroscopic procedures were n.s. associated with higher log odds of passing the test (p = 0.423), the points scored in the pretest were found to be a good predictor of whether a trainee would pass the test (p < 0.05). A positive correlation was observed between the points scored in the pretest and the posttest (p < 0.05, r = 0.59, r2 = 0.34).ConclusionsThe number of previously performed arthroscopies is not a reliable indicator of the skills level of orthopaedic residents. A reasonable alternative in the future would be to verify arthroscopic proficiency on the simulator by means of a score as a pass–fail examination.Level of evidenceIII.

Publisher

Wiley

Subject

Orthopedics and Sports Medicine,Surgery

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