Cognitive Training for Robotic Arm-Assisted Unicompartmental Knee Arthroplasty through a Surgical Simulation Mobile Application.

Abstract

Advances in mobile device technology combined with the implementation of surgical simulation have led to the development of novel applications (apps) as a potential learning tool for surgical trainees. Touch Surgery (TS) (Kinosis Limited, London, United Kingdom) is a mobile-based app that combines cognitive task analysis with a virtual reality medium to familiarize the user with a surgical procedure through interactive rehearsal. The purpose of this study was to compare the educational efficacy of the TS app with a traditional paper-based learning program in performing a robotic arm-assisted unicompartmental knee arthroplasty. Twelve participants (four interns, four residents, four adult reconstructive fellows) were randomized to a paper-based technique guide or learning modules from the Mako Partial Knee (Stryker, Mahwah, NJ) TS app. Trainees were subjected to a baseline pretest. After preparing with the allocated training tool, participants completed an immediate posttest followed by a retention test administered 3 weeks later. The TS simulation group demonstrated greater improvement (22% score increase; p = 0.001) in posttest assessment compared with the control group (10% score increase; p = 0. 09). The TS simulation group demonstrated better information recall compared with the control group based on the score differential following the 3-week retention test. This randomized comparative study demonstrated that the TS app was better than traditional paper-based learning for both immediate posttest performance and long-term information recall of the Mako robotic arm-assisted unicompartmental knee arthroplasty. Surgical simulation apps may be an effective learning tool for surgical trainees.