Teaching and proficiency assessment for arthroscopy in veterinary surgery: A 2017 survey of diplomates and residents of the American and European College of Veterinary Surgeons

Abstract

Objective To determine current methods of arthroscopic skills training and proficiency assessment, identify skills considered fundamental to arthroscopy, and evaluate desire for a formal training and assessment program. Study design Anonymized electronic survey. Sample population Diplomates and residents of the American College of Veterinary Surgeons (ACVS) and European College of Veterinary Surgeons (ECVS). Methods An electronic survey was distributed in commercial software (Qualtrics, Provo, Utah). Questions were divided into 4 categories: (1) demographics, (2) arthroscopy experience, (3) teaching, and (4) proficiency assessment. Descriptive statistical analysis was performed. Comparisons between groups were performed by using χ2, t tests, and 1‐way ANOVA (P ≤ .05). Results In total, 429 diplomates and 149 residents responded (response rate 28%). Overall, 80% of respondents trained using clinical cases. Barriers to simulator training included cadaver/simulator availability and time. Skills deemed most fundamental included anatomic knowledge, precise portal placement, triangulation, and image orientation. Overall, 90% of respondents supported a formal training program with requirement to demonstrate proficiency; 80% believed this should be part of standard ACVS/ECVS residency training. Conclusion Arthroscopic skills are taught by using clinical cases, with subjective proficiency assessment. Fundamental skills are those that may be taught using simulators. There is enthusiasm for formal arthroscopic skills training and assessment. Clinical significance Improved acquisition and assessment of fundamental arthroscopic skills is indicated. A validated methodology for formal training using simulators, minimizing morbidity, and facilitating objective evaluation is warranted. This is the first phase of a project to develop and validate a simulator program.

A survey of work‐related musculoskeletal disorders associated with performing laparoscopic veterinary surgery

“…It is possible that there is some crossover between membership of different groups, and the actual number of individuals is fewer. As such, the lowest possible response rate is 6%, which is lower than a comparable minimally invasive surgery survey . Nevertheless, 149 respondents for a survey designed specifically for veterinary surgeons performing laparoscopic surgery was deemed a good response.…”

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“…In a survey regarding arthroscopy, it was found that large animal veterinarians have more access to cadaver training than their small animal correspondents, and the lack of time, supervision, and resources were listed as the main impediments. The other categories of trainers were not used by the majority of the surgeons, with the lack of availability being primarily cited [38].…”

Trained to cut? A literature review of veterinary surgical resident training

“…According to multiple survey studies, most veterinary surgery residency programs teach using an apprenticeshipstyle approach to learning, primarily facilitated by direct interactions between the mentor and mentee while working through requirements and a clinical case log as required by the ACVS. 21,23,24 Outside of the clinical experience and direct mentor instruction, resources and additional training are provided through textbook and journal article review, morbidity and mortality rounds, case rounds, and participation in skills practice on models and/or cadavers. 21 Private practice surgical residencies are becoming more common; presently, five of the 39 ACVS large animal residency training locations are private practices, and 54 of the 82 small animal residency training sites are private practices.…”

“…However, the completion of the required case log is the only requirement from which to infer skill acquisition during a veterinary surgical residency, and objective grading of surgical skill proficiency is rarely, if ever, performed by residency programs. 21,24 Human medical residency programs also rely on minimum case requirements to infer skill acquisition and have lamented the inherent limitations to this system, stating "there is little value in setting absolute minimum case volume requirements in the absence of direct evaluations of operative competence." 27 The ACVS residency programs do require that objective assessment of technical skills occur frequently during resident training by surgical supervisors and mentors.…”

“…Proficiency assessment is a relatively new concept in the training of veterinary surgical residents, with minimally invasive training leading the field. 24 Several methods for providing objective assessments have already been developed for veterinary students undergoing surgical training, including procedure-specific checklists and global rating scales. [28][29][30][31][32][33][34][35] Similarly, numerous scales have been described for assessing human surgical residents' skills on clinical cases, cadavers, and simulators, although none have been found to be clearly superior.…”