Fundamentals of Arthroscopic Surgery Training Program Shows Transfer Validity Through Enhanced Operative Arthroscopic Performance

Abstract

PURPOSE: To evaluate the content, construct, concurrent, and transfer validity of the Fundamentals of Arthroscopic Surgery Training (FAST) program and to determine whether FAST testing performance correlated with arthroscopic performance in the operating room. METHODS: Participants were postgraduate years 1 to 3 (PGY1-3) orthopaedic residents from 7 programs who completed a 2-day FAST Training and Surgical Skills Assessment Course at the Orthopaedic Learning Center in February 2020. Residents underwent pre/postcourse surgical skills assessment in the operating room to determine baseline skills and measure transfer validity. Performance on surgical cases was measured using the Arthroscopic Surgical Skill Evaluation Tool, American Board of Orthopaedic Surgery's Operative Performance Score (O-Score), and the Procedure-Specific Checklist Tool (P-Tool). Baseline, training, and postcourse FAST testing was completed. Construct, concurrent, and content validity were assessed. RESULTS: Thirty-four (100%) participants completed the curriculum; 100% of residents and faculty agreed that FAST training improved arthroscopic skills (content validity). Expert-novice comparisons showed significant performance differences for 5 of 6 modules (construct validity). Post-training pass rates improved across all modules except the maze. Each FAST module passed correlated with a 1.24-point increase in Arthroscopic Surgical Skill Evaluation Tool score for simulated cadaveric arthroscopy (P < .001) and improved VirtaMed knee and shoulder simulator metrics (concurrent validity). Each FAST module passed correlated with a 3.86 (P < .001) Arthroscopic Surgical Skill Evaluation Tool (0-33 scale) improvement, a 4.52 (P < .001) American Board of Orthopaedic Surgery's O-Score (8-40 scale) improvement, and a 1.29 (P < .001) American Board of Orthopaedic Surgery's Procedure-Specific Tool (1-5 scale) improvement in the operating room (transfer validity). CONCLUSIONS: Performance on the FAST testing was significantly associated with improved arthroscopic performance on cadaveric, simulated, and live surgical assessments, showing content, construct, concurrent, and transfer validity within this cohort. CLINICAL RELEVANCE: The FAST program provides a structured, measurable method for developing fundamental arthroscopic skills early in orthopaedic residency, offering programs an evidence-based option for standardized assessment and targeted skills training.