A Reliable and Valid Objective Structured Assessment of Technical Skill for the Application of a Pavlik Harness Based on International Expert Consensus

Bradley, Catharine S.; Moktar, Joel; Maxwell, Alexandra; Wedge, John H.; Murnaghan, M. Lucas; Kelley, Simon P.

doi:10.1097/bpo.0000000000000557

Cited by 9 publications

(12 citation statements)

References 18 publications

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“…While the OSATS metric has been extensively utilized and validated for the evaluation of resident’s performance of technical skills, 7 , 9 , 10 , 25 its use as a tool to evaluate the efficacy of simulation laboratories has only been recently described. 11 – 16 , 26 Anderson and colleagues suggested that any study that utilized the OSATS as a stand-alone assessment measure ignored critical objective assessments regarding the end product of the tested technical procedure.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Bioskills Training for Simulated Open Lumbar Laminectomy

Boody

Rosenthal

Jenkins

et al. 2017

Global Spine Journal

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Study Design:Randomized, prospective study within an orthopedic surgery resident program at a large urban academic medical center.Objectives:To develop an inexpensive, user-friendly, and reproducible lumbar laminectomy bioskills training module and evaluation protocol that can be readily implemented into residency training programs to augment the clinical education of orthopedic and neurosurgical physicians-in-training.Methods:Twenty participants comprising senior medical students and orthopedic surgical residents. Participants were randomized to control (n = 9) or intervention (n = 11) groups controlling for level of experience (medical students, junior resident, or senior resident). The intervention group underwent a 40-minute bioskills training module, while the control group spent the same time with self-directed study. Pre- and posttest performance was self-reported by each participant (Physician Performance Diagnostic Inventory Scale [PPDIS]). Objective outcome scores were obtained from a blinded fellowship-trained attending orthopedic spine surgeon using Objective Structured Assessment of Technical Skills (OSATS) and Objective Decompression Score metrics.Results:When compared with the control group, the intervention group yielded a significant mean improvement in OSATS (P = .022) and PPDIS (P = .0001) scores. The Objective Decompression Scores improved in the intervention group with a trend toward significance (P = .058).Conclusions:We conclude that a concise lumbar laminectomy bioskills training session can be a useful educational tool for to augment clinical education. Although no direct clinical correlation can be concluded from this study, the improvement in trainee’s technical and procedural skills suggests that Sawbones training modules can be an efficient and effective tool for teaching fundamental spine surgical skills outside of the operating room.

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Section: Discussionmentioning

confidence: 99%

The Effectiveness of Bioskills Training for Simulated Open Lumbar Laminectomy

Boody

Rosenthal

Jenkins

et al. 2017

Global Spine Journal

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“…While the OSATS metric has been extensively utilized and validated for the evaluation of resident's performance of technical skills, [10][11][12][13][14][15] its use as a tool to evaluate the efficacy of simulation laboratories has only been recently described. 6,8,9,26 Anderson and colleagues suggested that any study that utilized the OSATS as a stand-alone assessment measure ignored critical objective assessments regarding the end product of the tested technical procedure. 27 For this reason, we supplemented the OSATS evaluation with direct evaluation of pedicle screw placement.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Bioskills Training for Simulated Lumbar Pedicle Screw Placement

Boody

Hashmi

Rosenthal

et al. 2017

Global Spine Journal

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Study Design:Prospective randomized study.Objectives:To define the impact of an inexpensive, user-friendly, and reproducible lumbar pedicle screw instrumentation bioskills training module and evaluation protocol.Methods:Participants were randomized to control (n = 9) or intervention (n = 10) groups controlling for level of experience (medical students, junior resident, or senior resident). The intervention group underwent a 20-minute bioskills training module while the control group spent the same time with self-directed study. Pre- and posttest performance was self-reported (Physician Performance Diagnostic Inventory Scale [PPDIS]). Objective outcome scores were obtained from a blinded fellowship-trained attending orthopedic spine surgeon using Objective Structured Assessment of Technical Skills (OSATS) and Objective Pedicle Instrumentation Score metrics. In addition, identification of pedicle breach and breach anatomic location was measured pre- and posttest in lumbar spine models.Results:The intervention group showed a 30.8% improvement in PPDIS scores, compared with 13.4% for the control group (P = .01). The intervention group demonstrated statistically significant 66% decrease in breaches (P = .001) compared with 28% decrease in the control group (P = .06). Breach identification demonstrated no change in accuracy of the control group (incorrect identification from 32.2% pre- to posttest 35%; P = .71), whereas the intervention group’s improvement was statistically significant (42% pre- to posttest 36.5%; P = .0047).Conclusions:We conclude that a concise lumbar pedicle screw instrumentation bioskills training session can be a useful educational tool to augment clinical education.

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“…Verbal instructions were later incorporated as narration, as shown in Video 1 (online). The steps and instructions provided in the video followed those previously identified in a validated OSATS for Pavlik harness application 15 . Video editing was performed using Adobe Premiere Pro software (Adobe Systems) and was timed to allow the viewer the opportunity to practice on the simulator model as the steps were explained on the video.…”

Section: Methodsmentioning

confidence: 99%

“…evaluated all videos using the OSATS and a global rating scale (GRS) for the assessment of performance and final product, which are specific to Pavlik harness application. The OSATS, developed according to international expert consensus using Delphi methodology, is a twenty-five-item rating scale that evaluates the steps required for appropriate Pavlik harness application 15 . Inter-rater and test-retest reliability of all three measures are considered excellent at, respectively, 0.96 and 0.98 for the OSATS; 0.90 and 0.93 for the GRS performance; and 0.93 and 0.94 for the GRS product 15 .…”

Section: Methodsmentioning

confidence: 99%

“…The OSATS, developed according to international expert consensus using Delphi methodology, is a twenty-five-item rating scale that evaluates the steps required for appropriate Pavlik harness application 15 . Inter-rater and test-retest reliability of all three measures are considered excellent at, respectively, 0.96 and 0.98 for the OSATS; 0.90 and 0.93 for the GRS performance; and 0.93 and 0.94 for the GRS product 15 . These previously established reliability measures obviated the need for multiple reviewers of the videos.…”

Section: Methodsmentioning

confidence: 99%

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Skill Acquisition and Retention Following Simulation-Based Training in Pavlik Harness Application

Moktar

Bradley

Maxwell

et al. 2016

The Journal of Bone and Joint Surgery

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Background:Simulation-based learning is increasingly prevalent in many surgical training programs, as medical education moves toward competency-based curricula. In orthopaedic surgery, developmental dysplasia of the hip is a commonly treated condition, where the standard of care for patients less than six months of age is an orthotic device such as the Pavlik harness. However, despite widespread use of the Pavlik harness and the potential complications that may arise from inappropriate application, we know of no previously described formal training curriculum for Pavlik harness application.Methods:We developed a video and model-based simulation learning module for Pavlik harness application. Two novice groups (residents and allied health professionals) were exposed to the module and, at pre-intervention, post-intervention, and retention testing, were evaluated on their ability to apply a Pavlik harness to the model. Evaluations were completed using a previously validated Objective Structured Assessment of Technical Skills (OSATS) and a global rating scale (GRS) specific to Pavlik harness application. A control group that did not undergo the module was also evaluated at two time points to determine if exposure to the Pavlik harness alone would affect skill acquisition. All groups were compared with a group of clinical experts, whose scores were used as a competency benchmark. Statistical analysis of skill acquisition and retention was conducted using t tests and analysis of variance (ANOVA).Results:Exposure to the learning module improved resident and allied health professionals’ competency in applying a Pavlik harness (p < 0.05) to the level of the expert clinicians, and this level of competency was retained one month after exposure to the module. Control subjects who were not exposed to the module did not improve, nor did they achieve competency.Conclusions:The simulation-based learning module was shown to be an effective tool for teaching the application of a Pavlik harness, and learners demonstrated retainable skills post-intervention. This learning module can form the cornerstone of formal teaching of Pavlik harness application for developmental dysplasia of the hip.

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A Reliable and Valid Objective Structured Assessment of Technical Skill for the Application of a Pavlik Harness Based on International Expert Consensus

Abstract: Level II.

Cited by 9 publications

References 18 publications

The Effectiveness of Bioskills Training for Simulated Open Lumbar Laminectomy

The Effectiveness of Bioskills Training for Simulated Open Lumbar Laminectomy

The Effectiveness of Bioskills Training for Simulated Lumbar Pedicle Screw Placement

Skill Acquisition and Retention Following Simulation-Based Training in Pavlik Harness Application

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