Assessing Residents’ Performance Prior to Performing Surgery
“Prior to the ARTHRO Mentor, we were unable to assess if our residents were ready to perform arthroscopy other than in the Operating Room.”
McLaren Flint Healthcare is a large community hospital affiliated with Michigan State University College of Human Medicine. The Orthopedic Surgery and Sports Medicine residency is a 5-year program where the residents perform over 200 different kinds of procedures including thousands of reconstruction of hips, knees, shoulders and other major joints of the body.
”Our goal at McLaren, ‘Doing what’s best’, is the backbone of our entire philosophy. It’s what inspires us to keep setting the bar higher and higher. It showcases our unwavering commitment to excellence and compassion for every patient we treat.”1
Matthew Sardelli, MD, Orthopedic Surgeon specializing in Sports Medicine at McLaren Flint explained, “We found that residents beginning the five year residency program didn’t have the necessary skills to succeed in the operating room as it pertained to arthroscopy. They didn’t know how to hold the instrumentation nor operate with the arthroscope. Although they had the theoretical knowledge of the anatomy and different surgical approaches, when it came to performing arthroscopy of the shoulder, hip, and knee, they lacked a basic comfort level with the instrumentation and spatial orientation to perform these procedures.”
“We were looking for a simulator that would give our residents both the tactile feel of the arthroscope and different surgical instruments as well as a realistic simulation, providing basic surgical and three dimensional skills and specific hands-on training in orthopedic procedures,” said Dr. Sardelli. “Equally important was a means to measure the residents’ acquirement of those skills before they actually performed them in the operating room.” said Dr. Sardelli.
McLaren Flint Healthcare purchased Surgical Science’ ARTHRO Mentor simulator for hands-on practice of basics skills and procedures.
In the beginning, the ARTHRO Mentor was used by the residents on a voluntary basis and they would come in when they wanted to practice different skills and procedures. Now it has been fully integrated into the residency curriculum. Residents are required to successfully complete different modules each year and their proficiency is assessed by pre-defined benchmarks.
Benefits and Advantages
According to Dr. Sardelli, the benefits and advantages of the ARTHRO Mentor for their Orthopedic Surgery residency program are:
Realistic Hardware – The tactile feel of the arthroscope resembles the instrument in real life. It “allows for real-time force feedback so that the residents know where they are inside the knee and shoulder, and whether they are causing articular damage or hitting instrumentation.”
Realistic Simulation – Dr. Sardelli stated “the simulation is very innovative and realistic. It replicates so accurately the real anatomy so that you see exactly how the joints and tissues behave when you move or apply pressure with the arthroscope or implant various surgical instruments such as shavers and biters.”
He added that breaking the procedures into specific tasks allows for practicing every step of the procedure again and again so when you do the procedure in real life situation, you can easily remember the steps of the procedure.
Educational Content – “What stood out was the quality of the educational content”, said Dr. Sardelli. The library of modules provides different levels of difficulty from basic skills tasks to complex procedures. A variety of anatomies are available from normal to difficult or rare, allowing the residents to progress according to their level of proficiency.
Metrics in Performance Reports – “What I like about the Surgical Science’ performance reports,” explained Dr. Sardelli, “is that they allow us to set proficiency levels or benchmarks for those metrics we feel are important for our Orthopedic Surgery Residency curriculum. We expect the residents to achieve these levels in order to proceed to the next step in the program.”
In reviewing the performance reports, educators can see the residents’ accuracy as well as their errors and if they have achieved the required proficiency level and are ready to operate in the OR.
Service – The service provided by Surgical Science was an important factor in McLaren Flint Healthcare’s decision to select the ARTHRO Mentor as service personnel are readily available.
The ARTHRO Mentor has changed McLaren Flint’s residency program. Now there is a training system that monitors the residents’ progress. “The simulator allows for real-time tactile force feedback so that the residents know where they are in the knee, hip or shoulder” as they learn in a comfortable, convenient and risk-free setting outside the operating room.
“Prior to the ARTHRO Mentor, we were unable to assess whether or not the residents were ready to perform arthroscopy other than in the operating room. Now, we have a very good idea of what they are capable of and I feel much more comfortable allowing them to participate in cases on actual patients, said Dr. Sardelli.”