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

Abstract

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.

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

“…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.…”