Study
Tool
Description
Conclusion
Howells et al. [10]
Modified orthopaedic competence assessment project (OCAP)
Intraoperative 14 point arthroscopic checklist and OSATS GRS
Tool demonstrated improved performance in operating room for simulator trained individuals compared to untrained control
Insell et al. [7]
The basic arthroscopic knee scoring system (BAKSS)
Combined task-specific checklist and GRS for diagnostic arthroscopy and partial meniscectomy
System able to discriminate people with different levels of arthroscopic experience
Elliott et al. [8]
Arthroscopic skill assessment form (Knee)
100 points score, 75 for structure identification, 25 for time completion and deductions for cartilage damage
Can distinguish between novice, experienced and expert surgeon in cadaveric knee
Schantz et al. [12]
The objective assessment of arthroscopic skills (OAAS)
Global skills domains with 5 skill level option combines with 13 point anatomical area checklist
Discriminates between various skill level of training, high level of consistency and test-retest reliability
Tuijthof [13]
Arthroscopic surgery skill evaluation tool (ASSET)
Global skills domain with 8 skill level option additional 1 domain for complexity using procedural video
Discriminates between novice, competent and expert level of training
Analysing these GRS, one can conclude that a certain level of consensus exists on arthroscopic skills that a resident should be able to demonstrate in the operating theatre and the required level to qualify as competent. OCAP is not specifically tested, but its items are derived from the well-established OSATS GRS, which has been validated extensively. The four other GRS have been validated for construct, content and concurrent validity as well as internal consistency, interrater and test-retest reliability. These results are summarised in Table 9.2.
Table 9.2
All GRS that are suggested for rating of arthroscopic skills based on Hodgins and Veillette [14]
Acronyms of global rating scales | Description | Validation |
|---|---|---|
OCAP | 9 items, scored on a 1–5 point Likert scale | Based on OSATS validation protocols |
BAKSSS | 10 items, scored on a 1–5 point Likert scale | Construct validity level of experience (p < 0.05) |
Concurrent validity with year of residency (r = 0.93) | ||
Concurrent validity with motion analysis (r = 0.58) (Alvand et al. [15]) | ||
Internal consistency (Cronbach’s α = 0.88) (Alvand et al. [15]) | ||
Interrater reliability (kappa = 0.543) (Olson et al. [16]) | ||
ASA | 100-point score, 75 for structure identification, 25 for time to completion and penalties for cartilage damage | Construct validity level of experience (p < 0.001) |
OAAS | 7 items, scored on a 1–5 point Likert scale, complexity of procedure | Construct validity level of experience (p < 0.0001)
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