Assessment of Technical Skills of Orthopaedic Surgery Residents Performing Open Carpal Tunnel Release Surgery

Heest, Ann E. Van; Putnam, Matthew D.; Agel, Julie; Shanedling, Janet; McPherson, Scott A.; Schmitz, Constance C.

doi:10.2106/jbjs.i.00024

Cited by 64 publications

(39 citation statements)

References 14 publications

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“…We perceive a real concern that among residents, the gap between expected performance and actual performance has increased in the last 20 years [9,17]. Given the alarming statistics regarding resident preparedness [9], we believe a reasonable restructuring of residency programs should be considered.…”

Section: Recommendationsmentioning

confidence: 99%

CORR ® Curriculum — Orthopaedic Education: Developing Safe, Independent Practitioners

Dougherty

DeMaio

DeRosa

2015

Clinical Orthopaedics &Amp; Related Research

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Section: Recommendationsmentioning

confidence: 99%

CORR ® Curriculum — Orthopaedic Education: Developing Safe, Independent Practitioners

Dougherty

DeMaio

DeRosa

2015

Clinical Orthopaedics &Amp; Related Research

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“…OSATS-based assessments have also been used in orthopaedics [16][17][18]. However, not all factors that influence orthopaedic surgical outcomes are amenable to expert visual evaluation, and these factors may be equally or more important than directly observable technical expertise.…”

Section: Introductionmentioning

confidence: 99%

Objective Structured Assessments of Technical Skills (OSATS) Does Not Assess the Quality of the Surgical Result Effectively

Anderson

Long

Thomas

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Performance assessment in skills training is ideally based on objective, reliable, and clinically relevant indicators of success. The Objective Structured Assessment of Technical Skill (OSATS) is a reliable and valid tool that has been increasingly used in orthopaedic skills training. It uses a global rating approach to structure expert evaluation of technical skills with the experts working from a list of operative competencies that are each rated on a 5-point Likert scale anchored by behavioral descriptors. Given the observational nature of its scoring, the OSATS might not effectively assess the quality of surgical results. Questions/purposes (1) Does OSATS scoring in an intraarticular fracture reduction training exercise correlate with the quality of the reduction? (2) Does OSATS scoring in a cadaveric extraarticular fracture fixation exercise correlate with the mechanical integrity of the fixation?Methods Orthopaedic residents at the University of Iowa (six postgraduate year [PGY]-1s) and at the University of Minnesota (seven PGY-1s and eight PGY-2s) undertook a skills training exercise that involved reducing a simulated intraarticular fracture under fluoroscopic guidance. Iowa residents participated three times during 1 month, and Minnesota residents participated twice with 1 month between their two sessions. A fellowship-trained orthopaedic traumatologist rated each performance using a modified OSATS scoring scheme. The quality of the articular reduction obtained was then directly measured. Regression analysis was performed between OSATS scores and two metrics of articular reduction quality: articular surface deviation and estimated contact stress. Another skills training exercise involved fixing a simulated distal radius fracture in a cadaveric specimen. Thirty residents, distributed across four PGY classes (PGY-2 and PGY-3, Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® n = 8 each; PGY-4 and PGY-5, n = 7 each), simultaneously completed the exercise at individual stations. One of three faculty hand surgeons independently scored each performance using a validated OSATS scoring system. The mechanical integrity of each fixation construct was then assessed in a materials testing machine. Regression analysis was performed between OSATS scores and two metrics of fixation integrity: stiffness and failure load. Results In the intraarticular fracture model, OSATS scores did not correlate with articular reduction quality (maximum surface deviations: R = 0.17, p = 0.25; maximum contact stress: R = 0.22, p = 0.13). Similarly in the cadaveric extraarticular fracture model, OSATS scores did not correlate with the integrity of the mechanical fixation (stiffness: R = 0.10, p = 0.60; failure load: R = 0.30, p = 0.10). Conclusions OSATS scoring methods do not effectively assess the quality of the surgical result. Efforts must be made to incorporate assessment metrics that reflect the quality of the surgical result. Clinical Relevance New objectiv...

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“…Yes, patient safety is paramount -but operating room time is limited. To ease this dilemma, residency programs have explored alternative surgical simulations [4,12,24,26] like cadaver skills labs, or more sophisticated simulators such as the arthroscopy knee simulator, which uses computer generated arthroscopy fields and tactile feedback (haptic feedback) to mimic real arthroscopic procedures.…”

Section: Teaching In the Operating Roommentioning

confidence: 99%

CORR® Curriculum — Orthopaedic Education: Faculty Development Begins at Home

Dougherty

2014

Clin Orthop Relat Res

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Assessment of Technical Skills of Orthopaedic Surgery Residents Performing Open Carpal Tunnel Release Surgery

Cited by 64 publications

References 14 publications

CORR ® Curriculum — Orthopaedic Education: Developing Safe, Independent Practitioners

CORR ® Curriculum — Orthopaedic Education: Developing Safe, Independent Practitioners

Objective Structured Assessments of Technical Skills (OSATS) Does Not Assess the Quality of the Surgical Result Effectively

CORR® Curriculum — Orthopaedic Education: Faculty Development Begins at Home

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