Prior Generic Arthroscopic Volume Correlates with Hip Arthroscopic Proficiency A Simulator Study
Prior Generic Arthroscopic Volume Correlates with Hip Arthroscopic Proficiency A Simulator Study
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DOI：
10.2106/jbjs.17.00352
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发表时间：
2018-01-03
影响因子：
5.3
通讯作者：
Rees, Jonathan L.
中科院分区：
文献类型：
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作者：
Erturan, Gurhan;Alvand, Abtin;Rees, Jonathan L.
背景：外科教育和患者期望的变化趋势正在导致熟练的进展模式和模拟器的使用。髋关节镜手术越来越多，并且有一个陡峭的学习曲线，主要在团契训练期间解决。这项研究的目的是评估以前的普通关节镜经验对模拟髋关节镜检查任务表现的影响，以估计与专家熟练程度相关的最小病例数，并帮助指导髋关节镜检查研究员的选择。方法：52名参与者被招募到一项横断面研究中。4名咨询师(髋关节镜专家)、28名实习生(住院医生和研究员)和20名新手(实习生和医学生)进行了标准化的台式模拟髋关节镜检查任务。使用经过验证的全球评价表(GRS)评分和运动分析来评估手术效果。以前的关节镜检查经验记录在外科电子日志中。受试者操作特征(ROC)曲线分析以确定专家和胜任GRS水平的任务熟练程度的最佳切入点。结果：基于GRS评估的所有经验组的关节镜能力与所有运动分析指标之间存在显著差异(P<；0.05)。航海日志编号与GRS评分呈显著正相关(p<；0.0001)。ROC曲线分析表明，至少需要610次关节镜检查才能获得专家GRS评分，78次关节镜检查才能获得合格的评分。结论：熟练地执行基本的髋关节镜检查任务需要大量的一般关节镜检查经验。这项研究确定的数字为居民提供了目标。被任命到髋关节镜检培训岗位的项目主任可能会发现这些结果在选择过程中作为指导有用。
Background: Changing trends in surgical education and patient expectation are leading to proficiency models of progression and the use of simulators. Hip arthroscopy is increasingly performed and has a steep learning curve mainly addressed during fellowship training. The aim of this study was to assess the impact of previous generic arthroscopic experience on performance at a simulated hip arthroscopy task to both estimate the minimum case numbers that correlate with expert proficiency levels and help to guide selection for hip arthroscopy fellowships.Methods: Fifty-two participants were recruited to a cross-sectional study. Four consultants (expert hip arthroscopists), 28 trainees (residents and fellows), and 20 novices (interns and medical students) performed a standardized bench-top simulated hip arthroscopy task. A validated global rating scale (GRS) score and motion analysis were used to assess surgical performance. Prior arthroscopic experience was recorded from surgical electronic logbooks. Receiver operating characteristic (ROC) curve analyses were conducted to identify optimum cut-points for task proficiency at both expert and competent GRS levels.Results: There were significant differences (p < 0.05) between the arthroscopic ability of all experience groups based on GRS assessment and for all motion analysis metrics. There was a significant positive correlation between logbook numbers and GRS scores (p < 0.0001). ROC curve analysis demonstrated that a minimum of 610 prior arthroscopic procedures were necessary to achieve an expert GRS score, and 78 prior arthroscopic procedures were necessary for a competent score.Conclusions: Performing a basic hip arthroscopy task competently requires substantial previous generic arthroscopic experience. The numbers identified in this study provide targets for residents. Program directors appointing to hip arthroscopy fellowship training posts may find these results useful as a guide during the selection process.