Evaluating a Diagnostic Ankle Arthroscopy Scoring System to Assess Competency in Orthopaedic Trainees

Category: Arthroscopy Introduction/Purpose: While there has been an increasing emphasis on assessing resident competency, little has been published on how to best evaluate competency for ankle arthroscopy. The purpose of this study was to design and validate an objective model for assessing basic ankle arthroscopy knowledge and surgical skills on a cadaveric ankle. Methods: The Basic Ankle Arthroscopy Skills Scoring System was adapted from previously validated assessment tools for knee arthroscopy. The scoring system includes (1) an oral questionnaire (0-23 points), (2) a surgical task-specific checklist (0-19 points), and (3) a global surgical skills rating (12-60 points). Ten medical students and twenty-three residents participated. All participants performed a diagnostic ankle arthroscopy on a cadaveric ankle and were assessed by a single observer. Six participants were tested by two evaluators to determine inter-observer reliability. Results: There was strong correlation between educational level and scores on the global surgical skills rating scale (r=0.967, p<0.0001), task-specific checklist (r=0.815, p<0.815), and oral questionnaire (r=0.896, p<0.0001). The global surgical skills scores were significantly different over multiple trainee levels but most notably between post graduate year (PGY) 1 and 2 (p<0.01) and between PGY 2 and 3 (p<0.05) [Figure 1a]. Oral questionnaire and task-specific checklists were significantly lower for medical students than PGY1 residents (p<0.001) [Figure 1b-c]. There was significant improvement in the oral questionnaire between senior and junior residents (p<0.05). There was a moderate correlation between number of ankle arthroscopy cases and scores on the global surgical skills score (r=0.7019, p<0.0001). Inter-observer reliability was high for the global surgical skills scores (ICC=0.89). Conclusion: The Basic Ankle Arthroscopy Skills Scoring System is a valid measure to objectively assess trainees’ ankle arthroscopy clinical knowledge and surgical skills in a bioskills laboratory. This tool will allow residency programs to evaluate competency and track individual progress over time.

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Assessment of Basic Ankle Arthroscopy Skills in Orthopedic Trainees

Foot & Ankle International ◽

10.1177/1071100719891418 ◽

2019 ◽

Vol 41 (2) ◽

pp. 193-199 ◽

Cited By ~ 2

Author(s):

Jeremiah D. Johnson ◽

Christopher Cheng ◽

Brian Schmidtberg ◽

Mark Cote ◽

Lauren E. Geaney

Keyword(s):

Medical Students ◽

Scoring System ◽

Rating Scale ◽

Interobserver Reliability ◽

Ankle Arthroscopy ◽

Assessment Tools ◽

Residency Programs ◽

Interclass Correlation ◽

Objective Model ◽

Junior Residents

Background: There is increasing emphasis on assessing resident competency, but little has been published on how to best evaluate trainee competency for ankle arthroscopy. The purpose of this study was to validate an objective model for assessing basic ankle arthroscopy knowledge and operative skills on a cadaveric ankle. Methods: The Diagnostic Ankle Arthroscopy Skills Scoring System was adapted from previously validated assessment tools for knee arthroscopy. The scoring system included (1) an oral questionnaire (0-23 points), (2) an operative task-specific checklist (0-19 points), and (3) a global operative skills rating (12-60 points). Thirty-three trainees consisting of orthopedic residents and medical students performed a diagnostic ankle arthroscopy on a cadaveric ankle and were assessed by a single observer, while a subset were tested by 2 evaluators to determine interobserver reliability. Results: There was strong correlation between educational level and scores on the global operative skills rating scale ( r = 0.967, P < .0001), task-specific checklist ( r = 0.815, P < .815), and oral questionnaire ( r = 0.896, P < .0001). The global operative skills scores significantly improved with training level, and the largest difference was between medical students and senior residents. The most notable year-to-year increases in skill were between postgraduate year (PGY) 1 and 2 ( P < .01) and between PGY2 and PGY3 ( P < .05). Oral questionnaire and task-specific checklists were significantly lower for medical students than PGY1 residents ( P < .001). There was also significant improvement in the oral questionnaire between senior and junior residents ( P < .05). There was a moderate correlation between number of self-reported ankle arthroscopy cases and scores on the global operative skills score ( r = 0.7019, P < .0001). Interobserver reliability was high for the global operative skills scores (interclass correlation coefficient = 0.89). Conclusion: The study revealed a valid measure to objectively assess trainees’ ankle arthroscopy clinical knowledge and operative skills in a bioskills laboratory. Clinical Relevance: This tool should enable residency programs to evaluate competency and track individual trainee progress over time.

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Aprendizagem Assistida por Pares: Uma Alternativa Pedagógica no Ensino de Competências a Estudantes de Medicina

Acta Médica Portuguesa ◽

10.20344/amp.12125 ◽

2020 ◽

Vol 33 (11) ◽

pp. 742

Author(s):

Joana Fernandes Ribeiro ◽

Manuel Rosete ◽

Andreia Teixeira ◽

Hugo Conceição ◽

Lèlita Santos

Keyword(s):

Medical Students ◽

Rating Scale ◽

Technical Skills ◽

Surgical Skills ◽

Global Rating Scale ◽

Control Group ◽

P Value ◽

Global Rating ◽

Learning Program ◽

Peer Assisted Learning

Introduction: Technical skills training is fundamental for clinical practice although poorly emphasised in undergraduate medical curricula. In these circumstances, Peer Assisted Learning methodology has emerged as a valid alternative to overcome this insufficiency. The purpose of this study is to evaluate the impact on students of a Peer Assisted Learning program in basic surgical skills, regarding technical competences and knowledge improvement.Material and Methods: A total of 104 randomly selected third year medical students participated in a workshop delivered by fifth year students. From that total, 34 students were assessed before and after the workshop, using the Objective Structured Assessment of Technical Skills instrument, that consists of a global rating scale and a procedure-specific checklist. Sixth year students (control group) were also assessed in their performance without participating in the workshop. Before workshop versus after workshop Objective Structured Assessment of Technical Skills results were compared using Wilcoxon and McNemar tests. After workshop versus control group Objective Structured Assessment of Technical Skills results were compared using Mann-Whitney, qui-squared test and Fisher’s exact test.Results: For the global rating scale, students obtained an after the workshop score (29.5) that was significantly higher than the before the workshop score (15.5; p-value < 0.001), but no significant differences were found between after the workshop and control group scores (p-value = 0.167). For the procedure-specific checklist, 3rd year students had a substantial positive evolution in all parameters and obtained higher rates of correct achievements compared to the control group.Discussion: The final outcomes demonstrated a significant qualitative and quantitative improvement of knowledge and technical skills, which is in accordance with other literature.Conclusion: This Peer Assisted Learning program revealed promising results concerning improvement of surgical skills in medical students, with little staff faculty contribution and extension to a much broader number of students.

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Surgical Skills Course Benefits Medical Students

Ob Gyn News ◽

10.1016/s0029-7437(08)70077-6 ◽

2008 ◽

Vol 43 (3) ◽

pp. 23

Author(s):

JEFF EVANS

Keyword(s):

Medical Students ◽

Surgical Skills

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Senior Medical Students’ Attitudes toward Choosing Residency Programs in Primary Care

American Journal of Preventive Medicine ◽

10.1016/s0749-3797(18)31398-9 ◽

1985 ◽

Vol 1 (4) ◽

pp. 38-43 ◽

Cited By ~ 1

Author(s):

Robert R. Franklin ◽

Pamela A. Samaha ◽

Janet C. Rice ◽

Susan M. Igras

Keyword(s):

Primary Care ◽

Medical Students ◽

Residency Programs ◽

Students Attitudes

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HUBUNGAN KECEMASAN DAN HASIL UAS-1 MAHASISWA BARU FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI MANADO TAHUN AJARAN 2012 / 2013

e-CliniC ◽

10.35790/ecl.1.2.2013.3283 ◽

2013 ◽

Vol 1 (2) ◽

Author(s):

Daniel Alberth Lallo ◽

L. F. Joyce Kandou ◽

Herdy Munayang

Keyword(s):

Medical Student ◽

Medical Students ◽

Coping Strategies ◽

Significant Relationship ◽

Odds Ratio ◽

Rating Scale ◽

Medical Faculty ◽

Anxiety Level ◽

Hamilton Anxiety Rating Scale ◽

Almost All

Abstrak: Kecemasan dialami oleh hampir semua orang di dunia, termasuk mahasiswa baru kedokteran. Mahasiswa baru kedokteran memiliki banyak stressor termasuk ujian yang menimbulkan kecemasan dan dapat mempengaruhi hasil ujian mereka. Sampai saat ini, hanya sedikit penyelidikan yang ditemukan menyelidiki fenomena ini. Di Fakultas Kedokteran Universitas Sam Ratulangi, tidak ada yang meneliti fenomena tersebut. Penelitian ini bertujuan untuk menilai hubungan antara kecemasan dan hasil ujian semester 1 (UAS-1) mahasiswa baru program studi kedokteran umum tahun akademik 2012/2013 di Universitas Sam Ratulangi. Ini merupakan penelitian analitik potong lintang dengan metode survei dan sensus sebagai cara dalam pengambilan sampel. Sampel penelitian yang telah memenuhi kriteria inklusi dan ekslusi didapatkan berjumlah 298 orang dari 319 mahasiswa baru program studi kedokteran umum tahun akademik 2012/2013 di Universitas Sam Ratulangi. Populasi tersebut kemudian diberi informed consent, kuesioner data sosiodemografi, dan dinilai kecemasannya menggunakan Hamilton Anxiety Rating Scale (HARS). Tidak ada hubungan yang signifikan antara kecemasan dan hasil UAS-1 (p=0,602>0,05). Ada hubungan yang signifikan antara jenis kelamin dan kecemasan (p=0,005<0,05) with odds ratio 2,91. 267 dari 298 mahasiswa (89,6%) mengalami kecemasan dengan kecemasan ringan sebagai tingkat kecemasan yang paling banyak ditemukan, berjumlah 177 orang (59,4%). Semua mahasiswa baru program studi kedokteran umum tahun akademik 2012/2013 di Universitas Sam Ratulangi mengalami kecemasan, terutama kecemasan ringan. Tidak terdapat hubungan antara kecemasan dengan hasil UAS-1 mereka, tetapi terdapat hubungan antara jenis kelamin dan kecemasan dengan kecenderuang hampir 3 kali bagi mahasiswa baru perempuan untuk mengalami kecemasan dibandingkan dengan mahasiswa baru laki-laki. Dibutuhkan penelitian lebih lanjut terkait coping strategies dan defense mechanism yang dilakukan mahasiswa untuk menganggulangi kecemasan mereka. Kata Kunci: Kecemasan, Ujian, Mahasiswa kedokteran. Abstract: Anxiety is experienced by almost all people around the world including new medical students. New medical student experiences a lot of stressor include examination which cause anxiety to occur and may affect their exam results. Somehow, there are a few study found to date that has investigate this phenomenon. In Sam Ratulangi University, which is the nearest medical faculty, there is no research for such phenomenon. This study aims to investigate the relationship between anxiety and new medical student’s achievement on their last exam in Medical Faculty of Sam Ratulangi University. This is an analytic research using a survey method with census as the option of sampling. However, the research samples are who meet inclusion category and not in the exclusion category. The nearest samples are in Sam Ratulangi University who are given questioners to measure their anxiety by using Hamilton Anxiety Rating Scale (HARS) before their exam and to collect their sosiodemograpic data as well. There is no significant relationship between anxiety and their last exam results (p=0,602>0,05), but there is a significant relationship between gender and anxiety (p=0,005<0,05) with odds ratio 2,91. According to anxiety test results, 267 of 298 grade-1 medical students (89,6%) present an anxiety and the most prevalence anxiety level is mild anxiety with total 177 people (59,4%). In conclusion, almost all grade-1 new medical students in Medical Faculty of Sam Ratulangi University experienced anxiety with mild anxiety as the most prevalence anxiety level. There is no significant relationship between anxiety and their last exam results, but there is a significant relationship between gender and anxiety with almost 3 times for new female medical students experiencing anxiety than new male medical students. Further research is needed to investigate coping strategies and defense mechanisms which may be used to cope with their anxiety. Keywords: Anxiety, Exam, Medical Student

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The Reliability of Ultrasound in the Assessment of Hyaline Cartilage in Rheumatoid Arthritis and Healthy Metacarpal Heads

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/a-1285-4602 ◽

2020 ◽

Author(s):

Edoardo Cipolletta ◽

Emilio Filippucci ◽

Andrea Di Matteo ◽

Giulia Tesei ◽

Micaela Ana Cosatti ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Scoring System ◽

Quantitative Assessment ◽

Hyaline Cartilage ◽

Scoring Systems ◽

Thickness Measurement ◽

Cartilage Thickness ◽

Observer Agreement ◽

Very High Frequency ◽

Observer Reliability

Abstract Purpose i) To assess the inter- and intra-observer reliability of ultrasound (US) in the evaluation of the hyaline cartilage (HC) of the metacarpal head (MH) in patients with rheumatoid arthritis (RA) and in healthy subjects (HS) both qualitatively and quantitatively. ii) To calculate the smallest detectable difference (SDD) of the MH cartilage thickness measurement. iii) To correlate the qualitative scoring system and the quantitative assessment. Materials and Methods US examination was performed on 280 MHs of 20 patients with RA and 15 HS using a very high frequency probe (up to 22 MHz). HC status was evaluated both qualitatively (using a five-grade scoring system) and quantitatively (using the average value of the longitudinal and transverse measures). The HC of MHs from II to V metacarpophalangeal joint of both hands were scanned independently on the same day by two rheumatologists to assess inter-observer reliability. All subjects were re-examined using the same scanning protocol and the same US setting by one sonographer after a week to assess intra-observer reliability. Results The inter-observer agreement and intra-observer agreement were moderate to substantial (k = 0.66 and k = 0.73) for the qualitative scoring system and high (ICC = 0.93 and ICC = 0.94) for the quantitative assessment. The SDD of the MH cartilage thickness measurement was 0.09 mm. A significant correlation between the two scoring systems was found (r = –0.35; p < 0.001). Conclusion The present study describes the main methodological issues of HC assessment. Using a standardized protocol, both the qualitative and the quantitative scoring systems can be reliable.

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Deferred Action for Childhood Arrivals (DACA) medical students – an examination of their journey and experiences as medical students in limbo

BMC Medical Education ◽

10.1186/s12909-021-02787-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Christina Gillezeau ◽

Wil Lieberman-Cribbin ◽

Kristin Bevilacqua ◽

Julio Ramos ◽

Naomi Alpert ◽

...

Keyword(s):

Medical Students ◽

Medical School ◽

First Year ◽

Convenience Sample ◽

Student Sample ◽

Medical Specialties ◽

Residency Programs ◽

Deferred Action ◽

The Status ◽

Depth Interviews

Abstract Background Although the value of DACA medical students has been hypothesized, no data are available on their contribution to US healthcare. While the exact number of DACA recipients in medical school is unknown, DACA medical students are projected to represent an increasing proportion of physicians in the future. The current literature on DACA students has not analyzed the experiences of these students. Methods A mixed-methods study on the career intentions and experiences of DACA medical students was performed utilizing survey data and in-depth interviews. The academic performance of a convenience sample of DACA medical students was compared to that of matriculated medical students from corresponding medical schools, national averages, and first-year residents according to specialty. Results Thirty-three DACA medical students completed the survey and five participated in a qualitative interview. The average undergraduate GPA (SD) of the DACA medical student sample was 3.7 (0.3), the same as the national GPA of 2017–2018 matriculated medical students. The most common intended residency programs were Internal Medicine (27.2%), Emergency Medicine (15.2%), and Family Medicine (9.1%). In interviews, DACA students discussed their motivation for pursuing medicine, barriers and facilitators that they faced in attending medical school, their experiences as medical students, and their future plans. Conclusions The intent of this sample to pursue medical specialties in which there is a growing need further exemplifies the unique value of these students. It is vital to protect the status of DACA recipients and realize the contributions that DACA physicians provide to US healthcare.

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Shortening the Frommelt Attitude Toward the Care Of the Dying Scale (FATCOD-B): a Brief 9-Item Version for Medical Education and Practice

Journal of Cancer Education ◽

10.1007/s13187-021-02020-3 ◽

2021 ◽

Author(s):

Giorgia Molinengo ◽

Barbara Loera ◽

Marco Miniotti ◽

Paolo Leombruni

Keyword(s):

End Of Life ◽

End Of Life Care ◽

Rating Scale ◽

Assessment Tools ◽

Scale Model ◽

Theory Approach ◽

Fit Indices ◽

Life Care ◽

Care Training ◽

Care Of The Dying

AbstractEnd-of-life care training has gaps in helping students to develop attitudes toward caring for the dying. Valid and reliable assessment tools are essential in building effective educational programmes. The Frommelt Attitude Toward the Care Of the Dying scale (FATCOD-B) is widely used to measure the level of comfort/discomfort in caring for the dying and to test the effectiveness of end-of-life care training. However, its psychometric properties have been questioned and different proposals for refinement and shortening have been put forward. The aim of this study is to get to a definitive reduction of the FATCOD-B through a valid and parsimonious synthesis of the previous attempts at scale revision. Data were gathered from a sample of 220 medical students. The item response theory approach was used in this study. Of the 14 items selected from two previous proposals for scale revision, 3 had a weak correlation with the whole scale and were deleted. The resulting 11-item version had good fit indices and withstood a more general and parsimonious specification (rating scale model). This solution was further shortened to 9 items by deleting 2 of 3 items at the same level of difficulty. The final 9-item version was invariant for gender, level of religiosity and amount of experience with dying persons, free from redundant items and able to scale and discriminate the respondents.

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Comparison of Frenotomy Techniques for the Treatment of Ankyloglossia in Children: A Systematic Review

Otolaryngology ◽

10.1177/0194599820917619 ◽

2020 ◽

Vol 163 (3) ◽

pp. 428-443

Author(s):

Usman Khan ◽

Jake MacPherson ◽

Michael Bezuhly ◽

Paul Hong

Keyword(s):

Rating Scale ◽

Pediatric Population ◽

Meta Analysis ◽

Numeric Rating Scale ◽

Assessment Tools ◽

Future Research ◽

Randomized Controlled ◽

Comprehensive Search ◽

High Level ◽

Numeric Rating

Objective To compare the effectiveness of conventional (CF), laser (LF), and Z-plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population. Data Sources A comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed. Review Methods Relevant articles were independently assessed by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Thirty-five articles assessing CF (27 articles), LF (4 articles), ZF (3 articles), and/or rhomboid plasty frenotomy (1 article) were included. A high level of outcome heterogeneity prevented pooling of data. All 7 randomized controlled trials (RCTs) were of low quality. Both CF (5 articles with 589 patients) and LF (2 articles with 78 patients) were independently shown to reduce maternal nipple pain on a visual analog or numeric rating scale. There were reports of improvement with breastfeeding outcomes as assessed on validated assessment tools for 88% (7/8) of CF articles (588 patients) and 2 LF articles (78 patients). ZF improved breastfeeding outcomes on subjective maternal reports (1 article with 18 infants) only. One RCT with a high risk of bias concluded greater speech articulation improvements with ZF compared to CF. Only minor adverse events were reported for all frenotomy techniques. Conclusions Current literature does not demonstrate a clear advantage for one frenotomy technique when managing children with ankyloglossia. Recommendations for future research are provided to overcome the methodological shortcomings in the literature. We conclude that all frenotomy techniques are safe and effective for treating symptomatic ankyloglossia.

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