Bone Joint J 2013;95-B:1445–9.

Reflections on current methods for evaluating skills during joint replacement surgery

R. Sonnadara, S. McQueen, P. Mironova, O. Safir, M. Nousiainen, P. Ferguson, B. Alman, W. Kraemer, R. Reznick
Ankle Elbow Hip Knee Shoulder Wrist

Valid and reliable techniques for assessing performance are essential to surgical education, especially with the emergence of competency-based frameworks. Despite this, there is a paucity of adequate tools for the evaluation of skills required during joint replacement surgery. In this scoping review, we examine current methods for assessing surgeons’ competency in joint replacement procedures in both simulated and clinical environments. The ability of many of the tools currently in use to make valid, reliable and comprehensive assessments of performance is unclear. Furthermore, many simulation-based assessments have been criticised for a lack of transferability to the clinical setting. It is imperative that more effective methods of assessment are developed and implemented in order to improve our ability to evaluate the performance of skills relating to total joint replacement. This will enable educators to provide formative feedback to learners throughout the training process to ensure that they have attained core competencies upon completion of their training. This should help ensure positive patient outcomes as the surgical trainees enter independent practice.


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