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Published in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2015

01-03-2015 | Sports Medicine

Construct validity testing of the Arthroscopic Knot Trainer (ArK)

Authors: Ivan H. Wong, Matthew Denkers, Nathan Urquhart, Forough Farrokhyar

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2015

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Abstract

Purpose

This study introduced a novel simulator called the Arthroscopic Knot Trainer (ArK) and reports preliminary evidence to support its construct validity. To our knowledge, the ArK is the first non-anatomical tissue reduction simulator designed to meet learning objectives specific for developing knot-tying skills.

Materials and methods

A step-by-step instructional video was used to teach orthopaedic residents how to tie an arthroscopic SMC knot. Residents were video recorded to assess time of completion, number of knots tied in 10 min and re-assessed 6 months later. Subjects were surveyed for content evidence after using the ArK. Data were analysed by paired t test and independent sample t test in order to compare the mean time to tie knots from test at baseline to retest at 6 months and the between group mean time, respectively.

Results

Content evidence supports the ArK trainer as appropriate for teaching and assessing arthroscopic knot-tying skills. Relation to other variables evidence supports the ArK trainer model whether stratified by year of training or by self-reported experience; time required for knot tying was inversely correlated with experience in tying arthroscopic knots. Internal structure evidence was supported with similar findings at retesting.

Conclusions

There are three sources of evidence supporting the construct validity of the ArK as a simulator for arthroscopic knot tying: content, relationship to other variable and internal structure evidence. The ArK is easy to use and has the capacity to distinguish between groups with different skill levels.

Level of evidence

II.
Literature
1.
go back to reference Anastakis DJ, Wanzel KR, Brown MH, McIlroy JH, Hamstra SJ, Ali J, Hutchison CR, Murnaghan J, Reznick RK, Regehr G (2003) Evaluating the effectiveness of a 2-year curriculum in a surgical skills center. Am J Surg 185:378–385CrossRefPubMed Anastakis DJ, Wanzel KR, Brown MH, McIlroy JH, Hamstra SJ, Ali J, Hutchison CR, Murnaghan J, Reznick RK, Regehr G (2003) Evaluating the effectiveness of a 2-year curriculum in a surgical skills center. Am J Surg 185:378–385CrossRefPubMed
2.
go back to reference Baumgarten KM, Wright RW (2010) Incorporating evidence-based medicine in arthroscopic knot preferences: a survey of American Orthopaedic Society for sports medicine members. Am J Ortho 39(12):577 Baumgarten KM, Wright RW (2010) Incorporating evidence-based medicine in arthroscopic knot preferences: a survey of American Orthopaedic Society for sports medicine members. Am J Ortho 39(12):577
4.
go back to reference Choy I, Okrainec A (2010) Simulation in surgery: perfecting the practice. Surg Clin North Am 90:457–473CrossRefPubMed Choy I, Okrainec A (2010) Simulation in surgery: perfecting the practice. Surg Clin North Am 90:457–473CrossRefPubMed
5.
go back to reference Cook DA, Beckman TJ (2006) Current concepts in validity and reliability for psychometric instruments: theory and application. Am J Med 119:166.e7–166.e16CrossRef Cook DA, Beckman TJ (2006) Current concepts in validity and reliability for psychometric instruments: theory and application. Am J Med 119:166.e7–166.e16CrossRef
6.
go back to reference Cristancho SM, Moussa F, Dubrowski A (2011) A framework-based approach to designing simulation-augmented surgical education and training programs. Am J Surg 202:344–351CrossRefPubMed Cristancho SM, Moussa F, Dubrowski A (2011) A framework-based approach to designing simulation-augmented surgical education and training programs. Am J Surg 202:344–351CrossRefPubMed
7.
8.
go back to reference Grober ED, Hamstra SJ, Wanzel KR, Reznick RK, Matsumoto ED, Sidhu RS, Jarvi KA (2004) The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures. Ann Surg 240:374CrossRefPubMedCentralPubMed Grober ED, Hamstra SJ, Wanzel KR, Reznick RK, Matsumoto ED, Sidhu RS, Jarvi KA (2004) The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures. Ann Surg 240:374CrossRefPubMedCentralPubMed
9.
go back to reference Insel A, Carofino B, Leger R, Arciero R, Mazzocca AD (2009) The development of an objective model to assess arthroscopic performance. J Bone Jt Surg Am 91:2287–2295CrossRef Insel A, Carofino B, Leger R, Arciero R, Mazzocca AD (2009) The development of an objective model to assess arthroscopic performance. J Bone Jt Surg Am 91:2287–2295CrossRef
10.
go back to reference Kim SH, Ha KI (2000) The SMC knot—a new slip knot with locking mechanism. Arthroscopy 16:563–565CrossRefPubMed Kim SH, Ha KI (2000) The SMC knot—a new slip knot with locking mechanism. Arthroscopy 16:563–565CrossRefPubMed
11.
go back to reference Kneebone R (2003) Simulation in surgical training: educational issues and practical implications. Med Educ 37:267–277CrossRefPubMed Kneebone R (2003) Simulation in surgical training: educational issues and practical implications. Med Educ 37:267–277CrossRefPubMed
12.
go back to reference Lipsett PA, Kern DE (2009) Step 6: evaluation and feedback. In: Kern DE, Thomas PA, Hughes MT (eds) Curriculum development for medical education: a six-step approach, 2nd edn. The Johns Hopkins University Press, Baltimore, pp 101–141 Lipsett PA, Kern DE (2009) Step 6: evaluation and feedback. In: Kern DE, Thomas PA, Hughes MT (eds) Curriculum development for medical education: a six-step approach, 2nd edn. The Johns Hopkins University Press, Baltimore, pp 101–141
13.
go back to reference Lo IKY, Ochoa E, Burkhart SS (2010) A comparison of knot security and loop security in arthroscopic knots tied with newer high-strength suture materials. Arthroscopy 26:S120–S126CrossRefPubMed Lo IKY, Ochoa E, Burkhart SS (2010) A comparison of knot security and loop security in arthroscopic knots tied with newer high-strength suture materials. Arthroscopy 26:S120–S126CrossRefPubMed
14.
go back to reference Mabrey JD, Gillogly SD, Kasser JR, Sweeney HJ, Zarins B, Mevis H, Garrett WE Jr, Poss R, Cannon WD (2002) Virtual reality simulation of arthroscopy of the knee. Arthroscopy 18:E28CrossRefPubMed Mabrey JD, Gillogly SD, Kasser JR, Sweeney HJ, Zarins B, Mevis H, Garrett WE Jr, Poss R, Cannon WD (2002) Virtual reality simulation of arthroscopy of the knee. Arthroscopy 18:E28CrossRefPubMed
15.
go back to reference Matsumoto ED, Hamstra SJ, Radomski SB, Cusimano MD (2002) The effect of bench model fidelity on endourological skills: a randomized controlled study. J Urol 167:1243–1247CrossRefPubMed Matsumoto ED, Hamstra SJ, Radomski SB, Cusimano MD (2002) The effect of bench model fidelity on endourological skills: a randomized controlled study. J Urol 167:1243–1247CrossRefPubMed
17.
go back to reference Moulton C-AE, Dubrowski A, MacRae H, Graham B, Grober E, Reznick R (2006) Teaching surgical skills: what kind of practice makes perfect? A randomized, controlled trial. Ann Surg 244:400–409PubMedCentralPubMed Moulton C-AE, Dubrowski A, MacRae H, Graham B, Grober E, Reznick R (2006) Teaching surgical skills: what kind of practice makes perfect? A randomized, controlled trial. Ann Surg 244:400–409PubMedCentralPubMed
19.
go back to reference Punjabi VM, Bokor DJ, Pelletier MH, Walsh WR (2011) The effect on loop elongation and stress relaxation during longitudinal loading of FiberWire in shoulder arthroscopic knots. Arthroscopy 27:750–754CrossRefPubMed Punjabi VM, Bokor DJ, Pelletier MH, Walsh WR (2011) The effect on loop elongation and stress relaxation during longitudinal loading of FiberWire in shoulder arthroscopic knots. Arthroscopy 27:750–754CrossRefPubMed
20.
21.
go back to reference Safir O, Dubrowski A, Williams C, Hui Y, Backstein D, Carnahan H (2012) The benefits of fundamentals of laparoscopic surgery (FLS) training on simulated arthroscopy performance. Stud Health Technol Inf 173:412–417 Safir O, Dubrowski A, Williams C, Hui Y, Backstein D, Carnahan H (2012) The benefits of fundamentals of laparoscopic surgery (FLS) training on simulated arthroscopy performance. Stud Health Technol Inf 173:412–417
22.
go back to reference Scott DJ, Cendan JC, Pugh CM, Minter RM, Dunnington GL, Kozar RA (2008) The changing face of surgical education: simulation as the new paradigm. J Surg Res 147:189–193CrossRefPubMedCentralPubMed Scott DJ, Cendan JC, Pugh CM, Minter RM, Dunnington GL, Kozar RA (2008) The changing face of surgical education: simulation as the new paradigm. J Surg Res 147:189–193CrossRefPubMedCentralPubMed
23.
go back to reference Srivastava S, Youngblood PL, Rawn C, Hariri S, Heinrichs WL, Ladd AL (2004) Initial evaluation of a shoulder arthroscopy simulator: establishing construct validity. J Should Elbow Surg 13:196–205CrossRef Srivastava S, Youngblood PL, Rawn C, Hariri S, Heinrichs WL, Ladd AL (2004) Initial evaluation of a shoulder arthroscopy simulator: establishing construct validity. J Should Elbow Surg 13:196–205CrossRef
24.
go back to reference Tavakol M, Mohagheghi MA, Dennick R (2008) Assessing the skills of surgical residents using simulation. J Surg Educ 65:77–83CrossRefPubMed Tavakol M, Mohagheghi MA, Dennick R (2008) Assessing the skills of surgical residents using simulation. J Surg Educ 65:77–83CrossRefPubMed
25.
go back to reference Tuijthof GJM, van Sterkenburg MN, Sierevelt IN, van Oldenrijk J, van Dijk CN, Kerkhoffs GMMJ (2010) First validation of the PASSPORT training environment for arthroscopic skills. Knee Surg Sports Traumatol Arthrosc 18:218–224CrossRefPubMed Tuijthof GJM, van Sterkenburg MN, Sierevelt IN, van Oldenrijk J, van Dijk CN, Kerkhoffs GMMJ (2010) First validation of the PASSPORT training environment for arthroscopic skills. Knee Surg Sports Traumatol Arthrosc 18:218–224CrossRefPubMed
26.
go back to reference Wanzel KR, Ward M, Reznick RK (2002) Teaching the surgical craft: from selection to certification. Curr Probl Surg 39:573–659CrossRefPubMed Wanzel KR, Ward M, Reznick RK (2002) Teaching the surgical craft: from selection to certification. Curr Probl Surg 39:573–659CrossRefPubMed
Metadata
Title
Construct validity testing of the Arthroscopic Knot Trainer (ArK)
Authors
Ivan H. Wong
Matthew Denkers
Nathan Urquhart
Forough Farrokhyar
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2524-x

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