Benchmark Development for Fundamental Arthroscopic Skills Using a Simulation-Based Training Program: Observational Study.

Abstract

Background: Surgical education has shifted from the traditional Halstedian apprenticeship model toward incorporating simulation due to work-hour restrictions, increasing case complexity, and economic and liability pressures. Building on the success of the Fundamentals of Laparoscopic Surgery program for general surgery, the Fundamentals of Arthroscopic Surgery Training (FAST) program was developed to establish proficiency benchmarks for orthopedic trainees in basic arthroscopic skills.

Objective: We aimed to establish benchmarks for 5 FAST workstation modules.

Methods: Sports medicine fellowship-trained faculty members were given instructions on the modules and 2 minutes of practice time, and they then performed each task 3 times with both their dominant and nondominant hand. For each module, mean faculty performance was used to establish an efficiency benchmark (time) and precision benchmark (errors).

Results: The Probing module should be completed in less than 95 seconds with no errors. The Ring Transfer module should be completed in less than 134 seconds with no more than 1 error. The Maze module should be completed in less than 99 seconds with no errors. The Meniscectomy module should be completed in less than 68 seconds with no more than 1 error. Lastly, the Suture Passing module should be completed in less than 195 seconds with no more than 1 error.

Conclusions: The FAST workstation can be used as a proficiency-based learning tool for residents to safely and effectively develop arthroscopic skills outside of the operating room. These benchmarks were established via a method previously validated in surgical simulation and balance precision and efficiency for skills that are considered generalizable and transferable to arthroscopic surgeries.