Koehler Ryan J, Goldblatt John P, Maloney Michael D, Voloshin Ilya, Nicandri Gregg T
Department of Orthopaedic Surgery, Vanderbilt Orthopaedic Institute, Vanderbilt University, Nashville, Tennessee, U.S.A..
Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, New York, U.S.A.
Arthroscopy. 2015 Dec;31(12):2314-9.e2. doi: 10.1016/j.arthro.2015.06.011. Epub 2015 Aug 28.
To determine the validity and reliability of using the Arthroscopic Surgery Skill Evaluation Tool (ASSET) to assess arthroscopic skill in the operating room.
Eight orthopaedic residents, 1 sports medicine fellow, and 3 sports medicine faculty members recorded the diagnostic portion of 3 shoulder and 3 knee procedures in the operating room. Two blinded raters used the ASSET to assess each recorded procedure video. Criterion for a passing score on a procedure was attaining a 3 or greater in all 8 domains assessed.
In total 70 videos (36 shoulder, 34 knee) were evaluated by each rater. The attending/fellow group was assigned significantly higher mean ASSET scores compared with resident groups for both procedures (P = .01). The attending/fellow group also had the highest passing percentage (95.8%). Raters were in agreement for total ASSET scores assigned to both diagnostic arthroscopy of the shoulder (intraclass correlation coefficient [ICC] = 0.84) and knee (ICC = 0.81). Agreement on individual ASSET domains was moderate (ICC = 0.61 to 0.80) for all domains except safety and difficulty of procedure. Raters concurred on the pass-fail evaluation in 62 of 70 (88.6%) of procedures evaluated.
Using the ASSET to assess surgical skills in the operating room is feasible, reliable, and valid.
When combined with previously published results using the ASSET, the ASSET may provide a validated and reliable method for evaluating arthroscopic surgical skills in the surgical simulation lab and operating room.
确定使用关节镜手术技能评估工具（ASSET）在手术室评估关节镜技能的有效性和可靠性。
8名骨科住院医师、1名运动医学研究员和3名运动医学教员在手术室记录了3例肩部和3例膝部手术的诊断部分。两名盲法评分者使用ASSET评估每个记录的手术视频。一项手术通过评分的标准是在所有8个评估领域中获得3分或更高分数。
每位评分者共评估了70个视频（36个肩部、34个膝部）。在这两种手术中，主治医生/研究员组的ASSET平均得分显著高于住院医师组（P = 0.01）。主治医生/研究员组的及格率也最高（95.8%）。评分者对肩部诊断性关节镜检查（组内相关系数[ICC]=0.84）和膝部诊断性关节镜检查（ICC = 0.81）的ASSET总分达成一致。除手术安全性和难度领域外，所有领域在ASSET各个领域的一致性为中等（ICC = 0.61至0.80）。在70例评估手术中的62例（88.6%）中，评分者对通过/失败评估意见一致。
使用ASSET在手术室评估手术技能是可行、可靠且有效的。
与之前使用ASSET发表的结果相结合时，ASSET可能为评估手术模拟实验室和手术室中的关节镜手术技能提供一种经过验证的可靠方法。
