TY - JOUR
T1 - A Proficiency-Based Progression Simulation Training Curriculum to Acquire the Skills Needed in Performing Arthroscopic Bankart and Rotator Cuff Repairs—Implementation and Impact
AU - Shoulder PBP Instructional Faculty
AU - Angelo, Richard L.
AU - St Pierre, Pat
AU - Tauro, Joe
AU - Gallagher, Anthony G.
AU - Barber, Alan
AU - Beach, William
AU - Burns, Joseph
AU - Caldwell, Paul
AU - Curtis, Alan
AU - Dodds, Julie
AU - Field, Larry
AU - Leland, Marty
AU - Getelman, Mark
AU - Hunter, Robert
AU - Kelly, John
AU - Kibler, Ben
AU - McIntyre, Louis
AU - Nicandri, Gregg
AU - Nord, Keith
AU - Pedowitz, Robert
AU - Richmond, John
AU - Snyder, Stephen
AU - Ticker, Jonathan
AU - Voloshin, Ilya
AU - Waterman, Brian
AU - Weber, Stephen
N1 - Funding Information:
This work was supported by Arthroscopy Association of North America Education Foundation.
Publisher Copyright:
© 2021
PY - 2021/4
Y1 - 2021/4
N2 - Purpose: To investigate the impact of a proficiency-based progression (PBP) curriculum employed to teach trainees in the skills needed to demonstrate proficiency for an arthroscopic Bankart repair (ABR) and an arthroscopic rotator cuff repair (ARCR) by objectively comparing pre- and immediate postcourse performances. Methods: In a prospective study, 16 arthroscopy/sports medicine fellows and 2 senior residents (complete group: N = 18) were randomly assigned to perform a precourse cadaveric ABR (Bankart subgroup: N = 6), ARCR (cuff subgroup: N = 6), or basic skills on a shoulder simulator (N = 6). After completing a PBP training curriculum, all 18 registrants performed both an ABR and ARCR scored in real time by trained raters using previously validated metrics. Results: The Bankart subgroup made 58% fewer objectively assessed errors at the completion of the course than at baseline (P =.004, confidence interval –1.449 to –0.281), and performance variability was substantially reduced (standard deviation = 5.89 vs 2.81). The cuff subgroup also made 58% fewer errors (P =.001, confidence interval –1.376 to 0.382) and showed a similar reduction in performance variability (standard deviation = 5.42 vs 2.1). Only one subject's precourse baseline performance met the proficiency benchmark compared with 89% and 83% of the all registrants on the final ABR and ARCR cadaveric assessments, respectively. Conclusions: The results of this study reject the null hypothesis. They demonstrate that the implementation of a PBP simulation curriculum to train the skills necessary to perform arthroscopic Bankart and rotator cuff repairs results in a large and statistically significant improvement in the trainee's ability to meet the 2 related performance benchmarks. Proficiency was demonstrated by 89% and 83% of the trainees for an ABR and an ARCR, respectively, in a two- and one-half day course. Clinical Relevance: Surgical training employing a PBP curriculum is efficient, effective, and has the potential to improve patient safety.
AB - Purpose: To investigate the impact of a proficiency-based progression (PBP) curriculum employed to teach trainees in the skills needed to demonstrate proficiency for an arthroscopic Bankart repair (ABR) and an arthroscopic rotator cuff repair (ARCR) by objectively comparing pre- and immediate postcourse performances. Methods: In a prospective study, 16 arthroscopy/sports medicine fellows and 2 senior residents (complete group: N = 18) were randomly assigned to perform a precourse cadaveric ABR (Bankart subgroup: N = 6), ARCR (cuff subgroup: N = 6), or basic skills on a shoulder simulator (N = 6). After completing a PBP training curriculum, all 18 registrants performed both an ABR and ARCR scored in real time by trained raters using previously validated metrics. Results: The Bankart subgroup made 58% fewer objectively assessed errors at the completion of the course than at baseline (P =.004, confidence interval –1.449 to –0.281), and performance variability was substantially reduced (standard deviation = 5.89 vs 2.81). The cuff subgroup also made 58% fewer errors (P =.001, confidence interval –1.376 to 0.382) and showed a similar reduction in performance variability (standard deviation = 5.42 vs 2.1). Only one subject's precourse baseline performance met the proficiency benchmark compared with 89% and 83% of the all registrants on the final ABR and ARCR cadaveric assessments, respectively. Conclusions: The results of this study reject the null hypothesis. They demonstrate that the implementation of a PBP simulation curriculum to train the skills necessary to perform arthroscopic Bankart and rotator cuff repairs results in a large and statistically significant improvement in the trainee's ability to meet the 2 related performance benchmarks. Proficiency was demonstrated by 89% and 83% of the trainees for an ABR and an ARCR, respectively, in a two- and one-half day course. Clinical Relevance: Surgical training employing a PBP curriculum is efficient, effective, and has the potential to improve patient safety.
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U2 - 10.1016/j.arthro.2020.11.040
DO - 10.1016/j.arthro.2020.11.040
M3 - Article
C2 - 33359814
AN - SCOPUS:85101196031
SN - 0749-8063
VL - 37
SP - 1099-1106.e5
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 4
ER -