Dwyer Tim, Schachar Rachel, Leroux Tim, Petrera Massimo, Cheung Jeffrey, Greben Rachel, Henry Patrick, Ogilvie-Harris Darrell, Theodoropoulos John, Chahal Jaskarndip
University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada; Women's College Hospital, Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada.
University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada.
Arthroscopy. 2017 Jul;33(7):1310-1318. doi: 10.1016/j.arthro.2017.01.047. Epub 2017 Mar 25.
To evaluate the use of dry models to assess performance of arthroscopic rotator cuff repair (RCR) and labral repair (LR).
Residents, fellows, and sports medicine staff performed an arthroscopic RCR and LR on a dry model. Any prior RCR and LR experience was noted. Staff surgeons assessed participants by use of task-specific checklists, the Arthroscopic Surgical Skill Evaluation Tool (ASSET), and a final overall global rating. All procedures were video recorded and were scored by a fellow blinded to the year of training of each participant.
A total of 51 participants and 46 participants performed arthroscopic RCR and LR, respectively, on dry models. The internal consistency or reliability (Cronbach α) using the total ASSET score for the RCR and LR was high (>0.9). One-way analysis of variance for the total ASSET score showed a difference between participants based on year of training (P < .001) for both procedures. The inter-rater reliability for the ASSET score was excellent (>0.9) for both procedures. A good correlation was seen between the ASSET score and the year of training, as well as the previous number of sports rotations.
The results of this study show evidence of construct validity when using dry models to assess performance of arthroscopic RCR and LR by residents.
The results of this study support the use of arthroscopic simulation in the training of residents and fellows learning arthroscopic shoulder surgery.
评估使用干式模型评估关节镜下肩袖修复术（RCR）和盂唇修复术（LR）的操作性能。
住院医师、研究员和运动医学工作人员在干式模型上进行关节镜下RCR和LR操作。记录任何既往的RCR和LR操作经验。指导医师使用特定任务清单、关节镜手术技能评估工具（ASSET）以及最终的整体综合评分对参与者进行评估。所有操作均进行视频记录，并由一名对每位参与者培训年份不知情的研究员进行评分。
分别有51名参与者和46名参与者在干式模型上进行了关节镜下RCR和LR操作。使用RCR和LR的ASSET总分得出的内部一致性或可靠性（Cronbach α）较高（>0.9）。对ASSET总分进行的单因素方差分析显示，基于培训年份，两种操作的参与者之间存在差异（P <.001）。两种操作的ASSET评分的评分者间信度均极佳（>0.9）。ASSET评分与培训年份以及之前的运动轮转次数之间存在良好的相关性。
本研究结果表明，在使用干式模型评估住院医师关节镜下RCR和LR操作性能时，存在结构效度的证据。
本研究结果支持在培训学习关节镜下肩部手术的住院医师和研究员时使用关节镜模拟。
