Does Arthroscopic Simulation Training Improve Triangulation and Probing Skills? A Randomized Controlled Trial✰

Abstract

To determine the effectiveness of simulator training on basic arthroscopic skills utilizing a novel, low-cost arthroscopic triangulation training system. A randomized controlled trial of subjects without prior arthroscopy training was conducted, with participants randomized to receive either a fixed protocol of simulation training on a triangulation simulation model (30 minutes of training for 4 consecutive days), or no training. On Days 1 and 5, all participants were evaluated on 3 simulated arthroscopic tasks by an independent observer. Variables analyzed included how many times portals were changed, the time it took to complete the tasks, and the task completion rate. Arthrex Inc., Naples, FL. Thirty-six participants (92% male, average 28 ± 5 years) with no prior arthroscopy training were randomized into 2 groups, with 17 in the training group (T) and 19 in the no-training group (NT). On Day 1, there was no difference in rate of task completion between the T group and NT groups (41% versus 53%, p = 0.52). On Day 5, significantly more participants in the T group completed all tasks compared to the NT group (100% versus 63%, p = 0.008). Participants in the T group had significantly improved task completion times on Day 5 versus Day 1 (p < 0.05). Participants in the NT group had a significantly improved task completion time for Task 1 on Day 5 versus Day 1 (p = 0.037); no differences were found for Tasks 2 or 3. On Day 5, participants in the T group required significantly fewer portal changes compared to the NT group (2.35 ± 2.29 versus 6.95 ± 8.55, p = 0.039). Simulation training on a simple, low-cost arthroscopic triangulation training system resulted in an overall improvement in arthroscopic probing and triangulation skills within 1 week of training, with significantly decreased task completion times and increased efficiency of movement.