Abstract：
OBJECTIVE: To investigate the feasibility of nonmedically trained evaluators and image- and video-based tools in the assessment of surgical skills in a key orthopedic procedure.
METHODS: Orthopedic surgeons at varying skill levels were evaluated by their ability to repair a cadaveric bi-malleolar ankle fracture. Nonphysician viewers and expert orthopedic surgeons independently scored video recordings and fluoroscopy images of the procedure through Global Rating Scales (GRS) and procedure-specific checklist tools. Statistical analysis was used to determine if the evaluators and assessment tools were able to differentiate skill level.
METHODS: An academic tertiary care hospital.
METHODS: The surgical procedure was completed by 3 orthopedic residents, 3 orthopedic trauma fellows, and 4 orthopedic trauma attending surgeons. The procedure was independently evaluated by 2 orthopedic surgeons and 2 nonphysicians.
RESULTS: Operating participants were stratified by ≤ or >10 bimalleolar ankle fracture cases performed alone (inexperienced, n = 5 vs experienced, n = 5). Expert surgeon viewers could effectively stratify skill group through the GRS for video and fluoroscopy analysis (p < 0.05), and the video procedure-specific checklist (p < 0.05), but not the fluoroscopy procedure-specific checklist. Nonphysician viewers generally recognized skill groupings, although with less separation than surgeon viewers. These evaluators performed the best when aided by video and fluoroscopy procedure-specific checklists. Meanwhile, breakdowns of each tool into critical zones for improvement and evaluator-independent metrics such as case experience, self-reported confidence, and surgical time also indicated some skill differentiation.
CONCLUSIONS: The feasibility of using video recordings and fluoroscopic imaging based surgical skills assessment tools in orthopedic trauma was demonstrated. The tools highlighted in this study are applicable to both cadaver laboratory settings and live surgeries. The degree of training that is required by the evaluators and the utility of measuring surgical times of specific tasks should be the subject of future studies.
METHODS: Orthopedic surgeons at varying skill levels were evaluated by their ability to repair a cadaveric bi-malleolar ankle fracture. Nonphysician viewers and expert orthopedic surgeons independently scored video recordings and fluoroscopy images of the procedure through Global Rating Scales (GRS) and procedure-specific checklist tools. Statistical analysis was used to determine if the evaluators and assessment tools were able to differentiate skill level.
METHODS: An academic tertiary care hospital.
METHODS: The surgical procedure was completed by 3 orthopedic residents, 3 orthopedic trauma fellows, and 4 orthopedic trauma attending surgeons. The procedure was independently evaluated by 2 orthopedic surgeons and 2 nonphysicians.
RESULTS: Operating participants were stratified by ≤ or >10 bimalleolar ankle fracture cases performed alone (inexperienced, n = 5 vs experienced, n = 5). Expert surgeon viewers could effectively stratify skill group through the GRS for video and fluoroscopy analysis (p < 0.05), and the video procedure-specific checklist (p < 0.05), but not the fluoroscopy procedure-specific checklist. Nonphysician viewers generally recognized skill groupings, although with less separation than surgeon viewers. These evaluators performed the best when aided by video and fluoroscopy procedure-specific checklists. Meanwhile, breakdowns of each tool into critical zones for improvement and evaluator-independent metrics such as case experience, self-reported confidence, and surgical time also indicated some skill differentiation.
CONCLUSIONS: The feasibility of using video recordings and fluoroscopic imaging based surgical skills assessment tools in orthopedic trauma was demonstrated. The tools highlighted in this study are applicable to both cadaver laboratory settings and live surgeries. The degree of training that is required by the evaluators and the utility of measuring surgical times of specific tasks should be the subject of future studies.
摘要：
目的：研究非医学培训的评估人员以及基于图像和视频的工具在评估骨科关键手术技术中的可行性。
方法：通过修复尸体双踝骨折的能力来评估不同技能水平的骨科医生。非医师观众和专业整形外科医生通过全球评级量表（GRS）和特定于程序的检查表工具对程序的视频记录和荧光图像进行了独立评分。使用统计分析来确定评估者和评估工具是否能够区分技能水平。
方法：一家学术三级护理医院。
方法：手术由3名骨科住院医师完成，3名骨科创伤研究员，和4名骨科创伤主治医生。该程序由2名骨科医师和2名非医师独立评估。
结果：手术参与者按≤或>10例双踝关节骨折病例进行分层（经验不足，n=5vs.n=5)。专家外科医生观众可以通过GRS有效地对技能组进行视频和透视分析（p<0.05），和视频程序特定的检查表(p<0.05)，但不是透视检查特定的检查表.非医师观众普遍认可的技能分组，尽管与外科医生观众相比分离较少。这些评估人员在视频和荧光透视检查特定检查表的帮助下表现最佳。同时,将每个工具分解为关键区域以进行改进和与评估者无关的指标，例如案例经验，自我报告的信心，手术时间也表明了一些技能差异。
结论：证明了在骨科创伤中使用基于视频记录和荧光成像的手术技能评估工具的可行性。本研究中强调的工具适用于尸体实验室设置和现场手术。评估人员所需的培训程度以及测量特定任务的手术时间的实用性应该是未来研究的主题。
方法：通过修复尸体双踝骨折的能力来评估不同技能水平的骨科医生。非医师观众和专业整形外科医生通过全球评级量表（GRS）和特定于程序的检查表工具对程序的视频记录和荧光图像进行了独立评分。使用统计分析来确定评估者和评估工具是否能够区分技能水平。
方法：一家学术三级护理医院。
方法：手术由3名骨科住院医师完成，3名骨科创伤研究员，和4名骨科创伤主治医生。该程序由2名骨科医师和2名非医师独立评估。
结果：手术参与者按≤或>10例双踝关节骨折病例进行分层（经验不足，n=5vs.n=5)。专家外科医生观众可以通过GRS有效地对技能组进行视频和透视分析（p<0.05），和视频程序特定的检查表(p<0.05)，但不是透视检查特定的检查表.非医师观众普遍认可的技能分组，尽管与外科医生观众相比分离较少。这些评估人员在视频和荧光透视检查特定检查表的帮助下表现最佳。同时,将每个工具分解为关键区域以进行改进和与评估者无关的指标，例如案例经验，自我报告的信心，手术时间也表明了一些技能差异。
结论：证明了在骨科创伤中使用基于视频记录和荧光成像的手术技能评估工具的可行性。本研究中强调的工具适用于尸体实验室设置和现场手术。评估人员所需的培训程度以及测量特定任务的手术时间的实用性应该是未来研究的主题。
