Abstract
BackgroundMost studies demonstrated, that training on a virtual reality based arthroscopy simulator leads to an improvement of technical skills in orthopaedic surgery. However, how long and what kind of training is optimal for young residents is unknown. In this study we tested the efficacy of a standardized, competency based training protocol on a validated virtual reality based knee- and shoulder arthroscopy simulator.MethodsTwenty residents and five experts in arthroscopy were included. All participants performed a test including knee -and shoulder arthroscopy tasks on a virtual reality knee- and shoulder arthroscopy simulator. The residents had to complete a competency based training program. Thereafter, the previously completed test was retaken. We evaluated the metric data of the simulator using a z-score and the Arthroscopic Surgery Skill Evaluation Tool (ASSET) to assess training effects in residents and performance levels in experts.ResultsThe residents significantly improved from pre- to post training in the overall z-score: − 9.82 (range, − 20.35 to − 1.64) to − 2.61 (range, − 6.25 to 1.5); p < 0.001. The overall ASSET score improved from 55 (27 to 84) percent to 75 (48 to 92) percent; p < 0.001. The experts, however, achieved a significantly higher z-score in the shoulder tasks (p < 0.001 and a statistically insignificantly higher z-score in the knee tasks with a p = 0.921. The experts mean overall ASSET score (knee and shoulder) was significantly higher in the therapeutic tasks (p < 0.001) compared to the residents post training result.ConclusionsThe use of a competency based simulator training with this specific device for 3-5 h is an effective tool to advance basic arthroscopic skills of resident in training from 0 to 5 years based on simulator measures and simulator based ASSET testing. Therefore, we conclude that this sort of training method appears useful to learn the handling of the camera, basic anatomy and the triangulation with instruments.
Highlights
Most studies demonstrated, that training on a virtual reality based arthroscopy simulator leads to an improvement of technical skills in orthopaedic surgery
A statistically significant improvement was found in all pre- to post training metric shoulder tasks and all except two metric knee tasks
The most important finding in this study is that a standardized, competency based training leads to significant improvements of arthroscopic skills measured by both, metric data as well as structured assessment of performance and safety using the Arthroscopic Surgery Skill Evaluation Tool (ASSET) score
Summary
That training on a virtual reality based arthroscopy simulator leads to an improvement of technical skills in orthopaedic surgery. In this study we tested the efficacy of a standardized, competency based training protocol on a validated virtual reality based knee- and shoulder arthroscopy simulator. Training of residents is a very important, but demanding and time consuming job in teaching hospitals. The. The potential 24/7 availability of a training tool is increasingly important since the hands-on operation time gets less for residents. In a previous study [14] it was shown that medical students have a steep learning curve in the first 2 hours of training on a virtual reality based knee arthroscopy simulator but there were no
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