Systematic instruction of arthroscopic knot tying with the ArK Trainer: an objective evaluation tool
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
A Proficiency Formula was introduced as an objective self-evaluation method for evaluating basic arthroscopic knot tying in a laboratory setting. The correlation between the Proficiency Formula and gold standard pass/fail dichotomy was demonstrated, as well as with other popular evaluation tools—task-specific checklist (TSC) and global rating scale (GRS).
A step-by-step video tutorial was used to instruct 35 medical students on how to tie an arthroscopic Samsung Medical Center (SMC) knot secured by three half hitches. Participants were video recorded performing arthroscopic knot tying and assessed on their success tying an SMC knot, pass or fail, and through three outcome tools: the Proficiency Formula, GRS and the TSC. Independent samples t test was used to compare the GRS, TSC and Proficiency Formula scores, between those who were passed or failed by the evaluators. Correlation between the measurement scales was tested using Spearman’s rho correlation coefficient.
Participants received a mean proficiency score of 195 (140–249). The mean Proficiency score for those that passed was 323 (95 % CI 272–374), for those that failed, 87 (95 % CI 26–148, p < 0.001). We found strong linear correlation between the Proficiency Formula and GRS and TSE (0.83 and 0.78, respectively).
The Proficiency Formula has high correlation with gold standard GRS and TSC measurements when used to assess arthroscopic knot tying skills on a model. It has the added advantage of being able to be self-assessed.
Level of evidence
- Bath J, Lawrence PF (2012) Twelve tips for developing and implementing an effective surgical simulation programme. Med Teach 34:192–197 CrossRef
- Beard JD, Jolly BC, Newble DI, Thomas WEG, Donnelly J, Southgate LJ (2005) Assessing the technical skills of surgical trainees. Br J Surg 92:778–782 CrossRef
- Chipman JG, Schmitz CC (2009) Using objective structured assessment of technical skills to evaluate a basic skills simulation curriculum for first-year surgical residents. J Am Coll Surg 209(364–370):e362
- Choy I, Okrainec A (2010) Simulation in surgery: perfecting the practice. Surg Clin North Am 90:457–473 CrossRef
- Cox M, Irby DM, Epstein RM (2007) Assessment in medical education. N Engl J Med 356:387–396 CrossRef
- Derossis AM, Fried GM, Abrahamowicz M, Sigman HH, Barkun JS, Meakins JL (1998) Development of a model for training and evaluation of laparoscopic skills. Am J Surg 175:482 CrossRef
- Fried GM, Feldman LS (2008) Objective assessment of technical performance. World J Surg 32:156–160 CrossRef
- Insel A, Carofino B, Leger R, Arciero R, Mazzocca AD (2009) The development of an objective model to assess arthroscopic performance. J Bone Joint Surg Am 91:2287–2295 CrossRef
- Issenberg SB, Gordon MS, Gordon DL, Safford RE, Hart IR (2001) Simulation and new learning technologies. Med Teach 23:16–23 CrossRef
- Kneebone R (2003) Simulation in surgical training: educational issues and practical implications. Simul Surg Train Educ Issues Pract Implic 37:267–277
- Mandel LP, Lentz GM, Goff BA (2000) Teaching and evaluating surgical skills. Obstet Gynecol 95:783–785 CrossRef
- Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, Brown M (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273–278 CrossRef
- Moorthy K, Munz Y, Sarker SK, Darzi A (2003) Objective assessment of technical skills in surgery. BMJ 327:1032–1037 CrossRef
- Naylor RA, Hollett LA, Valentine RJ, Mitchell IC, Bowling MW, Ma AM, Dineen SP, Bruns BR, Scott DJ (2009) Can medical students achieve skills proficiency through simulation training? Am J Surg 198:277–282 CrossRef
- Regehr G, MacRae H, Reznick RK, Szalay D (1998) Comparing the psychometric properties of checklists and global rating scales for assessing performance on an OSCE-format examination. Acad Med 73:993–997 CrossRef
- Reznick R, Regehr G, MacRae H, Martin J, McCulloch W (1997) Testing technical skill via an innovative “bench station” examination. Am J Surg 173:226–230 CrossRef
- Tavakol M, Mohagheghi MA, Dennick R (2008) Assessing the skills of surgical residents using simulation. J Surg Educ 65:77–83 CrossRef
- van Empel PJ, Verdam MGE, Strypet M, van Rijssen LB, Huirne JA, Scheele F, Bonjer HJ, Meijerink WJ (2012) Voluntary autonomous simulator based training in minimally invasive surgery, residents' compliance and reflection. J Surg Educ 69:564–570 CrossRef
- Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondré K, Stanbridge D, Fried GM (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190:107–113 CrossRef
- Wong I, Denkers M, Urquhart N, Farrokhyar F (2013) Construct Validity Testing of the Arthroscopic Knot (ArK) Trainer. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2524-x
- Systematic instruction of arthroscopic knot tying with the ArK Trainer: an objective evaluation tool
Knee Surgery, Sports Traumatology, Arthroscopy
- Print ISSN
- Online ISSN
- Additional Links
- Knot tying
- Industry Sectors
- Author Affiliations
- 1. 2nd Floor Rm 2106, QEII Camp Hill Veteran’s Memorial Building, 5655 Veterans’ Memorial Building, Halifax, NS, B3H 2E1, Canada
- 2. Hamilton General Hospital, 237 Barton Street E, 532 North Wing, Hamilton, ON, L8L2X2, Canada
- 3. 39 Charlton Ave East, Room 107, Hamilton, ON, L8N1Y3, Canada