Motion Analysis: A Validated Method for Showing Skill Levels in Arthroscopy

Howells, Nick; Brinsden, M; Gill, H. S.; Carr, Andrew; Rees, Jonathan

doi:10.1016/j.arthro.2007.08.033

Cited by 102 publications

(90 citation statements)

References 22 publications

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“…Procedure time and economy of motion have been shown to differentiate novice, intermediate, and skilled surgeons in other commercially available shoulder simulators [11,28]. Additionally, equipment movement and velocity captured by custommade motion capture devices on benchtop knee models have also been able to distinguish arthroscopic skill [13,29]. Interestingly, both novice and proficient subjects had similar roughness measures on the virtual simulator.…”

Section: Discussionmentioning

confidence: 93%

“…By the subjective GRS, the proficient group performed better on virtual (14 ± 6 [95% confidence interval {CI}, [10][11][12][13][14][15][16][17][18] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, multiple studies have shown that motion analysis and global rating scales were able to differentiate arthroscopic proficiency in knee and shoulder models and cadavers based on years of residency training [5,11,13,15,16,22,28,29]. Finally, Martin et al [20] have shown that performance on a shoulder simulator was similar to performance on a cadaver model.…”

Section: Introductionmentioning

confidence: 99%

“…Current literature has shown that both virtual and benchtop models, tested in isolation, can distinguish among novices, intermediate learners, and experienced arthroscopists [5,11,13,15,16,22,28,29]. However, to our knowledge, both virtual and benchtop models have not been compared concurrently in the same subjects.…”

Section: Introductionmentioning

confidence: 99%

“…Global rating scales (GRS), procedure times, and motion analysis metrics were used to evaluate performance. Results The proficient group scored higher on virtual (14 ± 6 [95% confidence interval {CI}, [10][11][12][13][14][15][16][17][18] Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request.…”

mentioning

confidence: 99%

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Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Chang

Banaszek

Gambrel

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Work-hour restrictions and fatigue management strategies in surgical training programs continue to evolve in an effort to improve the learning environment and promote safer patient care. In response, training programs must reevaluate how various teaching modalities such as simulation can augment the development of surgical competence in trainees. For surgical simulators to be most useful, it is important to determine whether surgical proficiency can be reliably differentiated using them. To our knowledge, performance on both virtual and benchtop arthroscopy simulators has not been concurrently assessed in the same subjects. Questions/purposes (1) Do global rating scales and procedure time differentiate arthroscopic expertise in virtual and benchtop knee models? (2) Can commercially available built-in motion analysis metrics differentiate arthroscopic expertise? (3) How well are performance measures on virtual and benchtop simulators correlated? (4) Are these metrics sensitive enough to differentiate by year of training? Methods A cross-sectional study of 19 subjects (four medical students, 12 residents, and three staff) were recruited and divided into 11 novice arthroscopists (student to Postgraduate Year [PGY] 3) and eight proficient arthroscopists (PGY 4 to staff) who completed a diagnostic arthroscopy and loose-body retrieval in both virtual and benchtop knee models. Global rating scales (GRS), procedure times, and motion analysis metrics were used to evaluate performance. CI, seconds, p = 0.002). The built-in motion analysis metrics also distinguished novices from proficient arthroscopists using the self-generated virtual loose body retrieval task scores (4 ± 1 [95% CI, 3-5] versus 6 ± 1 [95% CI, 5-7], p = 0.001). GRS scores between virtual and benchtop models were very strongly correlated (q = 0.93, p \ 0.001). There was strong correlation between year of training and virtual GRS (q = 0.8, p \ 0.001) and benchtop GRS (q = 0.87, p \ 0.001) scores. Conclusions To our knowledge, this is the first study to evaluate performance on both virtual and benchtop knee simulators. We have shown that subjective GRS scores and objective motion analysis metrics and procedure time are valid measures to distinguish arthroscopic skill on both virtual and benchtop modalities. Performance on both modalities is well correlated. We believe that training on artificial models allows acquisition of skills in a safe environment. Future work should compare different modalities in the efficiency of skill acquisition, retention, and transferability to the operating room.123 Clin Orthop Relat Res (2016) 474:956-964 DOI 10.1007/s11999-015-4510-8 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® GRS scales. The proficient subjects completed nearly all tasks faster

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Section: Discussionmentioning

confidence: 93%

“…By the subjective GRS, the proficient group performed better on virtual (14 ± 6 [95% confidence interval {CI}, [10][11][12][13][14][15][16][17][18] (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%