Berry Kirsty, von Bormann Richard, Roche Stephen, Laubscher Maritz, McCollum Graham, Held Michael
Registrar University of Cape Town, Orthopaedic Registrar University of Cape Town, South Africa.
Department of Department of Orthopaedic Surgery, University of Cape Town, Cape Town, South Africa.
JB JS Open Access. 2023 Jan 12;8(1). doi: 10.2106/JBJS.OA.22.00020. eCollection 2023 Jan-Mar.
Orthopaedic training in Southern Africa is largely focused on trauma, although elective procedures, such as knee arthroscopy, are increasing. This is especially true in the private sector where most trainees will practice. The primary aim of this study was to assess the arthroscopic competency of orthopaedic trainees in a setting of limited resources.
A prospective observational cohort study was conducted. Orthopaedic trainees of a Southern African university hospital performed basic arthroscopy on a knee model. Their surgical competency was assessed by 2 surgeons proficient in arthroscopy using the modified Basic Knee Arthroscopy Skill Scoring System (mBAKSSS).
A total of 16 trainees (12 male) were included (6 junior and 10 senior trainees). The median age of participants was 36 (34.8-37) years. The median mBAKSSS was 28.0 (20.3-32.5) but showed a large variability (12.0-42.5). The overall reliability was excellent with Cronbach's alpha of 0.91 and interclass correlation of 0.91 (95% confidence interval 0.75-0.97).
The average knee arthroscopy proficiency of our trainees is comparable with that of international training programs, but there was great variability with inconsistent skills among the trainees. This calls for improved and reproducible arthroscopy training and skills transfer, exposure to procedures, and ongoing assessment.
II (prospective observational cohort study).
南部非洲的骨科培训主要集中在创伤方面,不过诸如膝关节镜检查等择期手术的比例在不断增加。在大多数受训人员未来会从业的私营部门尤其如此。本研究的主要目的是在资源有限的情况下评估骨科受训人员的关节镜操作能力。
开展了一项前瞻性观察队列研究。一所南部非洲大学医院的骨科受训人员在膝关节模型上进行基本关节镜检查。由2名精通关节镜检查的外科医生使用改良的基本膝关节镜检查技能评分系统(mBAKSSS)对他们的手术能力进行评估。
共纳入16名受训人员(12名男性)(6名初级受训人员和10名高级受训人员)。参与者的年龄中位数为36(34.8 - 37)岁。mBAKSSS中位数为28.0(20.3 - 32.5),但显示出较大的变异性(12.0 - 42.5)。总体可靠性极佳,Cronbach's α为0.91,组内相关系数为0.91(95%置信区间0.75 - 0.97)。
我们的受训人员膝关节镜检查的平均熟练程度与国际培训项目相当,但受训人员之间技能差异很大且不稳定。这就需要改进并实现可重复的关节镜检查培训和技能传授、增加手术操作机会以及持续评估。
II级(前瞻性观察队列研究)。