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OBJECTIVE ASSESSMENT OF ARTHROSCOPIC SURGICAL SKILLS.

Oxford Centre for Orthopaedic Surgical Skills (OxCOSS), Nuffield Department of Orthopaedic Surgery, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD.

Background: Objective assessment of technical skill in orthopaedic surgery remains elusive. The general surgeons have validated a motion analysis model as a measurement of surgical ability for laparoscopic procedures. The aim of this study was to validate the motion analysis model in the context of simulated shoulder arthroscopy and use it to assess technical ability in a mixed population.

Methods: 35 volunteer subjects were recruited from the Oxford University Medical School and the Nuffield Orthopaedic Centre and stratified into groups according to their professional background. There were seven groups: consultant arthroscopic orthopaedic surgeons; senior orthopaedic SpRs (year 5/6); junior orthopaedic SpRs (year 1/2); basic surgical trainees; musculoskeletal physicians; graduate medical students; and hospital managers. Each subject completed a questionnaire to record previous arthroscopic experience and underwent psychometric testing. After receiving standardised instructions, each subject performed one diagnostic and one therapeutic procedure using the Alex Shoulder Professor (Sawbones Europe AB, Malmo, Sweden) model. The Patriot (Polhemus, Colchester, USA) electromagnetic tracking system was used to track hand movements during each procedure.

Results: We present the results of psychometric testing and motion analysis (time, distance and number of hand movements) data in subjects with a variety of experience of arthroscopic surgical techniques. We have demonstrated differences between the groups.

Conclusions: Objective assessment of arthroscopic surgical skills using motion analysis is valuable in identifying differing surgical abilities. We believe that this may help with the career development of trainees and in the development of specific teaching programmes for arthroscopic surgery.

Correspondence should be addressed to The Secretary, British Elbow and Shoulder Society, The Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.