Assessment of Technical Skills of Orthopaedic Surgery Residents Performing Open Carpal Tunnel Release Surgery

Van Heest, Ann; Putnam, Matthew; Agel, Julie; Shanedling, Janet; McPherson, Scott; Schmitz, Constance
December 2009
Journal of Bone & Joint Surgery, American Volume;Dec2009, Vol. 91-A Issue 12, p2811
Academic Journal
Background: Motor skills assessment is an important part of validating surgical competency. The need to test surgical skills competency has gained acceptance; however, assessment methods have not yet been defined or validated. The purpose of the present study was to evaluate the reliability and validity of four testing measures for the integrated assessment of orthopaedic surgery residents with regard to their competence in performing carpal tunnel release. Methods: Twenty-eight orthopaedic residents representing six levels of surgical training were tested for competence in performing carpal tunnel release on cadaver specimens. Four measures were used to assess competency. First, a web- based knowledge test of surgical anatomy, surgical indications, surgical steps, operative report dictation, and surgical complications was administered. Second, residents participated in an Objective Structured Assessment of Technical Skills; each resident performed surgery on a cadaver specimen. All residents were evaluated independently by two board-certified orthopaedic surgeons with a subspecialty certificate in hand surgery with use of a detailed checklist score, a global rating scale, and a pass/fail assessment. The time for completion of the surgery was also recorded. Each assessment tool was correlated with the others as well as with the resident's level of training. Results: Significant differences were found between year of training and knowledge test scores (F = 7.913, p < 0.001), year of training and detailed checklist scores (F = 5.734, p = 0.002), year of training and global rating scale (F = 2.835, p = 0.040), and year of training and percentage pass rate (F = 26.3, p < 0.001). No significant differences were found between year of training and time to completion of the carpal tunnel release (F = 2.482, p < 0.063). Conclusions: The results of the present study suggest that both knowledge and cadaver testing discriminate between novice and accomplished residents. However, although failure of the knowledge test can predict failure on technical skills testing, the presence of knowledge does not necessarily ensure successful performance of technical skills, as cognitive testing and technical skills testing are separate domains.


Related Articles

  • Percutaneous carpal tunnel release using nerve conduction monitoring requires no incisions. Gunther, Stephen B.; Bowen, William W.; Katasuura, Yoshihiro // Orthopedics Today;Mar2011, Vol. 31 Issue 3, p6 

    The article describes a percutaneous technique for the treatment of carpal tunnel syndrome, using nerve conduction monitoring and intraoperative patient feedback to perform the surgery without any incisions.

  • New cure for carpal tunnel.  // Men's Health;Sep97, Vol. 12 Issue 7, p177 

    Reports about the invasive surgery to relieve carpal-tunnel pain. Description of procedure; Length of time of invasive surgery; Cost of surgery.

  • WRIST RELIEF. FEINBERG, JOSEPH H. // Arthritis Today;May/Jun2011, Vol. 25 Issue 3, p85 

    The article provides an answer to a question on pain relief and treatment for carpal tunnel syndrome.

  • USE OF ARNICA TO RELIEVE PAIN AFTER CARPAL-TUNNEL RELEASE SURGERY. Jeffrey, S.L.A.; Belcher, H.J.C.R. // Alternative Therapies in Health & Medicine;Mar/Apr2002, Vol. 8 Issue 2, p66 

    Examines the effects of Arnica administration on the recovery after carpal-tunnel release recovery. Effectiveness of Arnica in reducing pain from hand surgery; Comparison between the performance of Arnica and placebos; Role of homeopathic and herbal agents on the recovery after surgery.

  • PERSPECTIVE. Ring, David C. // Orthopedics Today;Mar2011, Vol. 31 Issue 3, p9 

    The author assesses a proposed percutaneous technique for the treatment of carpal tunnel syndrome that uses nerve conduction monitoring and intraoperative patient feedback to perform the surgery without any incisions.

  • New endoscopic technique for carpal tunnel speeds recovery and lessens the risk of complications.  // Modern Medicine;Apr97, Vol. 65 Issue 4, p24 

    Focuses on a new endoscopic technique for carpal tunnel syndrome. Advantages of the technique over other procedures; Performance of the procedure with special instruments that can be rotated; Exhibition of grip strength that was near or greater that pre-op levels in patients who undergo the...

  • Nonoccupational risk factors for carpal tunnel syndrome. Solomon, Daniel H.; Katz, Jeffrey N.; Bohn, Rhonda; Mogun, Helen; Avorn, Jerry; Solomon, D H; Katz, J N; Bohn, R; Mogun, H; Avorn, J // JGIM: Journal of General Internal Medicine;May1999, Vol. 14 Issue 5, p310 

    Objective: To examine the relation between selected nonoccupational risk factors and surgery for carpal tunnel syndrome.Design: Case-control study using an administrative database.Participants: Enrollees of New Jersey Medicare or Medicaid programs during...

  • Carpal tunnel relief. Smith, S.L. // Occupational Hazards;Jan99, Vol. 61 Issue 1, p21 

    Reports on a surgical technique being performed by orthopedic surgeons at the University of Pittsburg Medical Center which they claim helps patients suffering from recurrent carpal tunnel syndrome. Description of procedure.

  • Local physician cuts carpal tunnel surgery time. Hayes, Tom // Indianapolis Business Journal;7/10/95, Vol. 16 Issue 15, p34 

    Reports on James Strickland's invention of a carpal tunnel hand surgery tool. Surgical procedure developed by Strickland; Background on carpal tunnel syndrome; Production of the surgical tool invention by Biomet Inc.; Traditional way for relieving carpal tunnel syndrome.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics