A basic arthroscopy course based on motor skill training

Abstract

Aim of this study is to introduce, evaluate, and propose a basic arthroscopy training course with interactive methods as using bovine knees, joint models but mainly focusing on practices with motor skill-learning devices. This study presents the results of a skill training program which is based on "motor skill training" theory and using "bovine knees" to simulate a specific task as arthroscopy both in education and evaluation. The participants gave feedback regarding their expectations, fulfillment, and self-evaluation on the degree of their improvement levels, after which their skills were evaluated by an expert while they performed the arthroscopic procedure. During this evaluation of the task, a four-dimensional checklist which was prepared previously by the consensus of three experts was used, and a global grading of each rater was added at the end of the checklist. In this 2-day course, small group teaching sessions are integrated with active and experiential learning methods consisting of short presentations by the educators, demonstrations using joint models and audio-visual teaching material, and significant continuous feedback by the teachers during the proceedings. Participants' expectations and post-course feedback results were obtained using a brief questionnaire which involved mostly open-ended questions. The self-rating of "own basic diagnostic arthroscopy skill" on a scale of 0-10 was completed by the participants both previous to and following the course to establish a student-centered learning environment. Overall rating of the course was asked on a 1-5 (poor-excellent) Likert scale. The questioning of the participants who took part in the course during the last five terms involved a 100% feedback. The overall rating of the course was 4.36 ± 0.47 on the 1-5 scale. The majority of the participants (90%) mentioned that the course met their expectations. The most beneficial activities were accepted to be the arthroscopic procedure applications on bovine knee, repetition of the manipulations under the supervision of the trainers, continuous feedback by experienced staff, and chance for immediate correction during the procedures (35/64). Pre- and post-course self-ratings of the participants inquiring about their ability to perform an arthroscopy alone showed significant improvement (4.2 vs. 7.7 P = 0.000, paired samples t test). All participants were found to be competent in the evaluation of their diagnostic arthroscopy skills on bovine knees. To design a skill teaching course based on the needs of the trainees, focusing on basic motor skill training exercises, and using bovine knee as a simulator is a safe, inexpensive, humanistic, and replicable method that proves a foundation for basic arthroscopic skills learning prior to patient encounter.

The timing and importance of motor skills course in knee arthroscopy training

“…In this context, authors displayed that efficient basic motor skills combined with visual spatial skills will provide a better performance before proceeding the surgical arthroscopy for real patients. 4 , 5 , 6 Similarly, in our study, we found that with the arthroscopy course, error of all physicians is lessened and process duration is shortened. Due to the lack of standards in orthopedic training, with reference to that such course has brought a standard to the resident training and has significant positive effect to the motor development, we believe, dissemination of these courses in orthopedic resident training and being a part of the orthopedic specialization training will be beneficial.…”

Creation of a Low-Cost Endoscopic Flavectomy Training Model

“…14 Simulators enable the development of basic motor, visual, and spatial skills, improving the performance of the surgeon performing a videoscopic procedure on a real patient. 8 Training becomes essential since the field of observation is limited and the capacity for instrument manipulation is reduced. 4 During the development of the simulator, we found it difficult to faithfully replicate the field of vision and the manipulation of materials using copper or PVC tubes because they had larger dimensions than real instruments.…”

“…7 Percutaneous endoscopic lumbar discectomy using the interlaminar technique has a steep learning curve due to the high technical demand. 8,9 The synthetic simulators available on the market for training in this technique are expensive, as they require usually imported high-tech devices, such as monitors, cameras, light sources and optics, limiting access to such training. 6 In this scenario, the objective of this study is to develop an accessible simulator of the endoscopic lumbar spine flavectomy technique.…”

Desarrollo de plan de entrenamiento con simulación de artroscopía para residentes de ortopedia

“…12 Estudios han demostrado mejoría de habilidades artroscópicas en los residentes después de recibir entrenamiento con cualquier tipo de simulador. 13,14,15,16 Sin embargo, se reconoce que actualmente hay poca consistencia en el uso de simuladores en enseñanza. 3,17 También se ha demostrado que tienen una buena capacidad de discriminación entre niveles de habilidad quirúrgica; aunque por el momento no se ha logrado documentar la transferibilidad de las habilidades del simulador al quirófano.…”