Chuang Hao-Chun, Kuan Fa-Chuan, Su Wei-Ren, Shih Chien-An, Chiang Chen-Hao, Ko Po-Yen, Hong Chih-Kai, Chen Yueh, Hsu Kai-Lan
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine National Cheng Kung University Tainan Taiwan.
Department of Biomedical Engineering National Cheng Kung University Tainan Taiwan.
J Exp Orthop. 2024 May 20;11(3):e12030. doi: 10.1002/jeo2.12030. eCollection 2024 Jul.
This study aimed to evaluate the effects and interactions of training level and different joints on the outcomes of cadaveric arthroscopic training courses for orthopaedic residents.
This prospective study enrolled 16 orthopaedic residents who voluntarily participated in a cadaveric training programme involving the shoulder, elbow, wrist, knee and ankle joints. Outcomes were quantitatively assessed using task-specific checklists and the Arthroscopic Surgery Skill Evaluation Tool. Two-way analysis of variance (ANOVA) was conducted to determine the significance of the interactions between joint and years of training.
Resident scores significantly increased after the dedicated lectures in all five joints ( = 0.003 for the shoulder module, < 0.001 for the other joints). Two-way ANOVA revealed that the progress made after the dedicated lectures was significantly impacted by the joint ( = 0.006) and training level × joint interaction ( = 0.005) but not by the training level ( = 0.47). The simple effect of the joint was examined using Sidak's multiple comparison test. Among junior residents, the dedicated lectures resulted in more substantial progress in elbow and wrist arthroscopy when compared to shoulder arthroscopy ( = 0.020 and = 0.043, respectively).
The results suggest that, in cadaveric arthroscopic training courses for orthopaedic residents, training outcomes are primarily impacted by the specific joint being trained rather than the training level. Specifically, junior residents demonstrated greater improvement with training in procedures that are less commonly encountered during on-the-job training, such as elbow and wrist arthroscopy.
These findings suggest the need to prioritise wrist and elbow arthroscopic training for junior residents to optimise educational outcomes.
Level III.
本研究旨在评估培训水平和不同关节对骨科住院医师尸体关节镜培训课程效果的影响及相互作用。
这项前瞻性研究招募了16名骨科住院医师，他们自愿参加了一项涉及肩、肘、腕、膝和踝关节的尸体培训项目。使用特定任务清单和关节镜手术技能评估工具对结果进行定量评估。进行双向方差分析（ANOVA）以确定关节与培训年限之间相互作用的显著性。
在所有五个关节的专门讲座后，住院医师的分数显著提高（肩部模块P = 0.003，其他关节P < 0.001）。双向方差分析显示，专门讲座后的进步受到关节（P = 0.006）和培训水平×关节相互作用（P = 0.005）的显著影响，但不受培训水平的影响（P = 0.47）。使用Sidak多重比较检验检查关节的简单效应。在初级住院医师中，与肩关节镜检查相比，专门讲座在肘关节镜检查和腕关节镜检查方面取得了更大的进步（分别为P = 0.020和P = 0.043）。
结果表明，在骨科住院医师的尸体关节镜培训课程中，培训结果主要受所培训的特定关节影响，而非培训水平。具体而言，初级住院医师在在职培训中较少遇到的手术（如肘关节镜检查和腕关节镜检查）培训中表现出更大的进步。
这些发现表明，需要优先为初级住院医师进行腕关节和肘关节镜培训，以优化教育成果。
三级。
