Validation of Assessing Arthroscopic Skill using the ASSET Evaluation

Raja, Avais; Thomas, Phillip; Harrison, Alicia K.; Tompkins, Marc; Braman, Jonathan P.

doi:10.1016/j.jsurg.2019.05.010

Cited by 7 publications

(2 citation statements)

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“…Middleton et al. [ 60 ] compared three GRS to assess simulated arthroscopic skills and found that none demonstrated superiority, although ASSET had the highest frequency of use (10 of 17 studies) and has been validated in many studies of joints such as the knee [ 39 , 61 ], shoulder [ 62 ], hip[ 63 ], ankle [ 33 ] and wrist [ 64 ]. Among all GRS, only ASSET has demonstrated reliability in both simulated and clinical environments [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

The frequency of assessment tools in arthroscopic training: a systematic review

et al. 2022

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Background Multiple assessment tools are used in arthroscopic training and play an important role in feedback. However, it is not fully recognized as to the standard way to apply these tools. Our study aimed to investigate the use of assessment tools in arthroscopic training and determine whether there is an optimal way to apply various assessment tools in arthroscopic training. Methods A search was performed using PubMed, Embase and Cochrane Library electronic databases for articles published in English from January 2000 to July 2021. Eligible for inclusion were primary research articles related to using assessment tools for the evaluation of arthroscopic skills and training environments. Studies that focussed only on therapeutic cases, did not report outcome measures of technical skills, or did not mention arthroscopic skills training were excluded. Results A total of 28 studies were included for review. Multiple assessment tools were used in arthroscopic training. The most common objective metric was completion time, reported in 21 studies. Technical parameters based on simulator or external equipment, such as instrument path length, hand movement, visual parameters and injury, were also widely used. Subjective assessment tools included checklists and global rating scales (GRS). Among these, the most commonly used GRS was the Arthroscopic Surgical Skill Evaluation Tool (ASSET). Most of the studies combined objective metrics and subjective assessment scales in the evaluation of arthroscopic skill training Conclusions Overall, both subjective and objective assessment tools can be used as feedback for basic arthroscopic skill training, but there are still differences in the frequency of application in different contexts. Despite this, combined use of subjective and objective assessment tools can be applied to more situations and skills and can be the optimal way for assessment. Level of Evidence Level III, systematic review of level I to III studies. Key messages Both subjective and objective assessment tools can be used as feedback for basic arthroscopic skill training. Combined use of subjective and objective assessment tools can be applied to more situations and skills and can be the optimal way for assessment.

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Section: Discussionmentioning

confidence: 99%

The frequency of assessment tools in arthroscopic training: a systematic review

et al. 2022

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“…Despite some critical comments [13, 36], many studies have shown that arthroscopic skills can not only be learned and trained on the simulator [5, 9, 10, 14, 32] but also objectively and reliably tested using skill scores [3, 8, 20, 24, 26, 30, 31, 39]. Although simulator training will never replace training in the operating theatre, it allows the measurement and documentation of the learning progress and is ideally suited to implement proficiency‐oriented skill training.…”

Section: Introductionmentioning

confidence: 99%

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

Anetzberger

Kugler²,

John³

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose It 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. Methods A total of 97 resident and early orthopaedic surgeons who participated in arthroscopic simulator training courses were divided into ive 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-ive points out of 100 must be achieved to pass the test. Results In 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 signiicantly 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 signiicant increase in performance. In group 5, participants scored 81 ± 17 points, which was signiicantly 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, r 2 = 0.34). Conclusions The 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 proiciency on the simulator by means of a score as a pass-fail examination. Level of evidence III.

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