Browsing by Author "Clark, Marcia"

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    Periprosthetic total knee fracture after remote reconstruction of the anterior cruciate ligament: a case report
    (2017-09-29) Kooner, Sahil; Gibson, Eric; Clark, Marcia
    Abstract Background Distal femoral fracture is a rare, but significant, postoperative complication of anterior cruciate ligament reconstruction. However, there has not been a reported case of periprosthetic total knee arthroplasty fracture associated with a previous anterior cruciate ligament repair. Case presentation We report the case of a 51-year-old white man with a history of total knee arthroplasty and remote anterior cruciate ligament reconstruction, who presented with a distal femoral periprosthetic fracture at the site of a previous anterior cruciate ligament augmentation staple. Conclusions Based on these findings, it may be important to consider removal of previous anterior cruciate ligament hardware prior to total knee arthroplasty to reduce risk of periprosthetic fracture, which should be determined on a patient-specific basis.
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    Using Kane’s framework to build an assessment tool for undergraduate medical student’s clinical competency with point of care ultrasound
    (2023-01-19) Sheppard, Gillian; Williams, Kerry-Lynn; Metcalfe, Brian; Clark, Marcia; Bromley, Mark; Pageau, Paul; Woo, Michael; Yi, Yanqing; Devasahayam, Augustine J.; Dubrowski, Adam
    Abstract Introduction Point-of-care ultrasonography (POCUS) is a portable imaging technology used in clinical settings. There is a need for valid tools to assess clinical competency in POCUS in medical students. The primary aim of this study was to use Kane’s framework to evaluate an interpretation-use argument (IUA) for an undergraduate POCUS assessment tool. Methods Participants from Memorial University of Newfoundland, the University of Calgary, and the University of Ottawa were recruited between 2014 and 2018. A total of 86 participants and seven expert raters were recruited. The participants performed abdominal, sub-xiphoid cardiac, and aorta POCUS scans on a volunteer patient after watching an instruction video. The participant-generated POCUS images were assessed by the raters using a checklist and a global rating scale. Kane’s framework was used to determine validity evidence for the scoring inference. Fleiss’ kappa was used to measure agreement between seven raters on five questions that reflected clinical competence. The descriptive comments collected from the raters were systematically coded and analyzed. Results The overall agreement between the seven raters on five questions on clinical competency ranged from fair to moderate (κ = 0.32 to 0.55). The themes from the qualitative data were poor image generation and interpretation (22%), items not applicable (20%), poor audio and video quality (20%), poor probe handling (10%), and participant did not verbalize findings (14%). Conclusion The POCUS assessment tool requires further modification and testing prior before it can be used for reliable undergraduate POCUS assessment.