A Portable Hip Arthroscopy Simulator Demonstrates Good Face and Content Validity with Incomplete Construct Validity

Aoife Feeley,Luke Turley,Eoin Sheehan,Khalid Merghani

doi:10.1016/j.asmr.2021.05.009

Abstract

PurposeWe evaluate the face, content, and construct validity of a portable hip arthroscopy module in a regional orthopaedic unit.MethodsParticipants were recruited from a regional orthopaedic centre, and categorized into novice (0 arthroscopies), intermediate (1-29 arthroscopies), and expert (>50 arthroscopies) groups based on reported experience in arthroscopy. Face and content validity was evaluated by feedback from users immediately following completion of modules. Objective measurements, including time taken and subjective measurements consisting of simulation software metrics including, cam lesion locations attempts, scope strikes on bone, healthy bone burred, and cam lesion burred. Scores achieved by experts were recorded, and the median score was set at the level at which proficiency was demonstrated. Participant feedback on perceived educational use was collected following completion.ResultsIn total, 20 participant results were included for analysis. Good face and content validity was expressed by participants with previous arthroscopic experience. Number of scope strikes within the simulator-derived metrics accurately discerned between levels of experience. Novices had a mean of 5 strikes per attempt (SD a mean of 5.8 strikes (SD 4.1). There was a significant difference between expert and novice groups (P = .01), and expert and intermediate groups (P = .002). No significant difference between overall performance scores achieved by participants in expert, intermediate, and novice groups (62% vs 55% vs 50% P = .15). This demonstrates incomplete construct validity of the simulator software-derived metrics.ConclusionsThis hip arthroscopy simulator demonstrated acceptable face and content validity, with incomplete construct validity of simulator software metrics. Participants reported high levels of satisfaction with the module, highlighting that the addition of haptic feedback would be beneficial to improve procedural steps. Incorporation of tactile feedback to the modulator components would likely enable the software to accurately delineate between levels of experience.Clinical RelevanceThis study demonstrates good face and content validity. The addition of haptic feedback in a hip arthroscopy simulator may improve learning.

Highlights

Hip arthroscopy is a procedure growing in popularity, with a multitude of indications, including intra-articular and periarticular conditions
This study demonstrated acceptable levels of face and content validity for the Precision OS Cam Lesion hip arthroscopy procedure, with incomplete construct validity demonstrated
Participants reported high levels of satisfaction with the module, highlighting that the addition of haptic feedback would be beneficial for improving procedural steps

Summary

Introduction

Hip arthroscopy is a procedure growing in popularity, with a multitude of indications, including intra-articular and periarticular conditions. Its use is Department of Trauma and Orthopaedic Surgery, Tullamore Hospital, Arden, Road, Tullamore, Co. Offaly, Ireland (A.F., L.T., E.S., K.M.); and Graduate Entry Medical School, University of Limerick, Castletroy, Limerick, Ireland (A.F., E.S.). Full ICMJE author disclosure forms are available for this article online, as supplementary material. With the introduction of the European working time directive[6] and shorter training schemes, surgical trainees face challenges, including increasingly complex surgical procedures[7] with reduced operative training time. With a high rate of newly qualified surgeons reporting insufficient experience to operate independently,[8,9] novel methods are required to counteract the training shortcomings encountered by surgical trainees

Methods

Results

Discussion

Conclusion