Simulation of Anterior Cruciate Ligament Reconstruction in a Dry Model
Notice bibliographique
Résumé
BACKGROUND: As the demand increases for demonstration of competence in surgical skill, the need for validated assessment tools also increases. HYPOTHESIS/PURPOSE: The purpose of this study was to validate a dry knee model for the assessment of performance of anterior cruciate ligament reconstruction (ACLR). The hypothesis was that the combination of a checklist and a previously validated global rating scale would be a valid and reliable means of assessing ACLR when performed by residents in a dry model. STUDY DESIGN: Controlled laboratory study. METHODS: All residents, sports medicine staff, and fellows were invited to perform a hamstring ACLR using anteromedial drilling and Endobutton fixation on a dry model of an anterior cruciate ligament. Previous exposure to knee arthroscopy and ACLR was recorded. A detailed surgical manuscript and technique video were sent to all participants before the study. Residents were evaluated by staff surgeons with task-specific checklists created by use of a modified Delphi procedure and the Arthroscopic Surgical Skill Evaluation Tool (ASSET). Each procedure (hand movements and arthroscopic video) was recorded and scored by a fellow blinded to the year of training of each participant. RESULTS: A total of 29 residents, 5 fellows, and 6 staff surgeons (40 participants total) performed an ACLR on the dry model. The internal reliability (Cronbach alpha) of the test when using the total ASSET score was very high (>0.9). One-way analysis of variance for the total ASSET score and the total checklist score demonstrated a difference between participants based on year of training (P < .001). Post hoc analysis demonstrated a significant difference in global ratings and checklist scores between junior residents (postgraduate year [PGY] 1-3) and senior residents (PGY 4 and 5) and senior residents and fellows (P < .05). A significant difference was seen between fellows and staff on the global rating (P < .05) but not on the checklist scores (P > .05). A good correlation was seen between the total ASSET score and prior exposure to knee arthroscopy (0.73) and ACLR (0.65). The interrater reliability (intraclass correlation coefficient) between the examiner ratings and the blinded assessor ratings for the total ASSET score was very high (>0.8). CONCLUSION: The results of this study provide evidence that the performance of an ACLR in a dry model is a reliable method of assessing a resident's knowledge of the steps and instrumentation required, and the method shows evidence of validity. CLINICAL RELEVANCE: These models may be used to ensure a minimal level of competence before residents and fellows perform ACLR in the operating room.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».