TY - JOUR

T1 - Practicing Procedural Skills Is More Effective Than Basic Psychomotor Training in Knee Arthroscopy

T2 - A Randomized Study

AU - Jacobsen, Mads Emil

AU - Gustafsson, Amandus

AU - Jørgensen, Per Gorm

AU - Park, Yoon Soo

AU - Konge, Lars

N1 - Publisher Copyright: © The Author(s) 2021.

PY - 2021

Y1 - 2021

N2 - Background: Simulator-assisted arthroscopy education traditionally consists of initial training of basic psychomotor skills before advancing to more complex procedural tasks. Purpose: To explore and compare the effects of basic psychomotor skills training versus procedural skills training on novice surgeons’ subsequent simulated knee arthroscopy performance. Study Design: Controlled laboratory study. Methods: Overall, 22 novice orthopaedic surgeons and 11 experienced arthroscopic surgeons participated in this study, conducted from September 2015 to January 2017. Novices received a standardized introductory lesson on knee arthroscopy before being randomized into a basic skills training group or a procedural skills training group. Each group performed 2 sessions on a computer-assisted knee arthroscopy simulator: The basic skills training group completed 1 session consisting of basic psychomotor skills modules and 1 session of procedural modules (diagnostic knee arthroscopy and meniscal resection), whereas the procedural skills training group completed 2 sessions of procedural modules. Performance of the novices was compared with that of the experienced surgeons to explore evidence of validity for the basic psychomotor training skills modules and the procedural modules. The effect of prior basic psychomotor skills training and procedural skills training was explored by comparing pre- and posttraining performances of the randomized groups using a mixed-effects regression model. Results: Validity evidence was found for the procedural modules, as test results were reliable and experienced surgeons significantly outperformed novices. We found no evidence of validity for the basic psychomotor skills modules, as test scores were unreliable and there was no difference in performance between the experienced surgeons and novices. We found no statistical effect of basic psychomotor skills training as compared with no training (P =.49). We found a statistically significant effect of prior procedural skills training (P <.001) and a significantly larger effect of procedural skills training as compared with basic psychomotor skills training (P =.019). Conclusion: Procedural skills training was significantly more effective than basic psychomotor skills training regarding improved performance in diagnostic knee arthroscopy and meniscal resection on a knee arthroscopy simulator. Furthermore, the basic psychomotor skills modules lacked validity evidence. Clinical Relevance: On the basis of these results, we suggest that future competency-based curricula focus their training on full knee arthroscopy procedures. This could improve future education programs.

AB - Background: Simulator-assisted arthroscopy education traditionally consists of initial training of basic psychomotor skills before advancing to more complex procedural tasks. Purpose: To explore and compare the effects of basic psychomotor skills training versus procedural skills training on novice surgeons’ subsequent simulated knee arthroscopy performance. Study Design: Controlled laboratory study. Methods: Overall, 22 novice orthopaedic surgeons and 11 experienced arthroscopic surgeons participated in this study, conducted from September 2015 to January 2017. Novices received a standardized introductory lesson on knee arthroscopy before being randomized into a basic skills training group or a procedural skills training group. Each group performed 2 sessions on a computer-assisted knee arthroscopy simulator: The basic skills training group completed 1 session consisting of basic psychomotor skills modules and 1 session of procedural modules (diagnostic knee arthroscopy and meniscal resection), whereas the procedural skills training group completed 2 sessions of procedural modules. Performance of the novices was compared with that of the experienced surgeons to explore evidence of validity for the basic psychomotor training skills modules and the procedural modules. The effect of prior basic psychomotor skills training and procedural skills training was explored by comparing pre- and posttraining performances of the randomized groups using a mixed-effects regression model. Results: Validity evidence was found for the procedural modules, as test results were reliable and experienced surgeons significantly outperformed novices. We found no evidence of validity for the basic psychomotor skills modules, as test scores were unreliable and there was no difference in performance between the experienced surgeons and novices. We found no statistical effect of basic psychomotor skills training as compared with no training (P =.49). We found a statistically significant effect of prior procedural skills training (P <.001) and a significantly larger effect of procedural skills training as compared with basic psychomotor skills training (P =.019). Conclusion: Procedural skills training was significantly more effective than basic psychomotor skills training regarding improved performance in diagnostic knee arthroscopy and meniscal resection on a knee arthroscopy simulator. Furthermore, the basic psychomotor skills modules lacked validity evidence. Clinical Relevance: On the basis of these results, we suggest that future competency-based curricula focus their training on full knee arthroscopy procedures. This could improve future education programs.

KW - arthroscopy simulator

KW - knee arthroscopy

KW - surgical education

KW - virtual reality

U2 - 10.1177/2325967120985129

DO - 10.1177/2325967120985129

M3 - Journal article

C2 - 33709006

AN - SCOPUS:85101780604

VL - 9

JO - Orthopaedic Journal of Sports Medicine

JF - Orthopaedic Journal of Sports Medicine

SN - 2325-9671

IS - 2

ER -