TY - JOUR

T1 - Assessment of Technical Competence in Distal Radius Fracture Fixation by A Volar Locking Plate

T2 - A Global Delphi Consensus Study

AU - Jacobsen, Mads Emil

AU - Nayahangan, Leizl Joy

AU - Ghidinelli, Monica

AU - Subramaniam, Chitra

AU - Hare, Kristoffer Borbjerg

AU - Konge, Lars

AU - Gustafsson, Amandus

N1 - Publisher Copyright: © 2023 American Society for Surgery of the Hand

PY - 2023

Y1 - 2023

N2 - Purpose: Volar locking plate fixation of distal radius fractures is a common orthopedic procedure and should be mastered by graduating orthopedic residents. Surgical education is transitioning from a traditional time-based approach to competency-based medical education. Valid and objective assessment is essential for successful transition. The purpose of this study was to develop a comprehensive, procedure-specific assessment tool to evaluate technical competence in volar locking plate osteosynthesis of a distal radius fracture. Methods: International orthopedic/trauma experts involved in resident education participated as panelists in a four-round online Delphi process to reach consensus on the content of the assessment tool. Round 1 was an item-generating round, in which the panelists identified potential assessment parameters. In round 2, the panelists rated the importance of each suggested assessment parameter and reached consensus on which to include in the assessment tool. Round 3 yielded specific assessment score intervals for specific bone and fracture models and is not reported in this study. In round 4, the panelists assigned weights to the assessment parameters on a 1–10 scale to determine how each parameter should have an impact on the overall results. Results: Eighty-seven surgeons, representing 42 countries, participated in the study. Round 1 resulted in 45 assessment parameters, grouped into five procedural steps. After round 2, the number of parameters was reduced to 39. After the final round, an additional parameter was removed and weights were assigned to the remaining parameters. Conclusions: Using a systematic methodology, a preliminary assessment tool to evaluate technical competence in distal radius fracture fixation was developed. A consensus of international experts supports the content validity of the assessment tool. Clinical relevance: This assessment tool represents the first step in the evidence-based assessment essential for competency-based medical education. Before implementation, further studies exploring validity of variations of the assessment tool in different educational contexts are required.

AB - Purpose: Volar locking plate fixation of distal radius fractures is a common orthopedic procedure and should be mastered by graduating orthopedic residents. Surgical education is transitioning from a traditional time-based approach to competency-based medical education. Valid and objective assessment is essential for successful transition. The purpose of this study was to develop a comprehensive, procedure-specific assessment tool to evaluate technical competence in volar locking plate osteosynthesis of a distal radius fracture. Methods: International orthopedic/trauma experts involved in resident education participated as panelists in a four-round online Delphi process to reach consensus on the content of the assessment tool. Round 1 was an item-generating round, in which the panelists identified potential assessment parameters. In round 2, the panelists rated the importance of each suggested assessment parameter and reached consensus on which to include in the assessment tool. Round 3 yielded specific assessment score intervals for specific bone and fracture models and is not reported in this study. In round 4, the panelists assigned weights to the assessment parameters on a 1–10 scale to determine how each parameter should have an impact on the overall results. Results: Eighty-seven surgeons, representing 42 countries, participated in the study. Round 1 resulted in 45 assessment parameters, grouped into five procedural steps. After round 2, the number of parameters was reduced to 39. After the final round, an additional parameter was removed and weights were assigned to the remaining parameters. Conclusions: Using a systematic methodology, a preliminary assessment tool to evaluate technical competence in distal radius fracture fixation was developed. A consensus of international experts supports the content validity of the assessment tool. Clinical relevance: This assessment tool represents the first step in the evidence-based assessment essential for competency-based medical education. Before implementation, further studies exploring validity of variations of the assessment tool in different educational contexts are required.

KW - Assessment of surgical skills

KW - competency-based medical education

KW - Delphi

KW - distal radius fracture

KW - volar locking plate

U2 - 10.1016/j.jhsa.2023.05.012

DO - 10.1016/j.jhsa.2023.05.012

M3 - Journal article

C2 - 37389496

AN - SCOPUS:85163806132

VL - 48

SP - 875

EP - 885

JO - Journal of Hand Surgery

JF - Journal of Hand Surgery

SN - 0363-5023

IS - 9

ER -