Abstract
PurposeTo test the face validity of the hip diagnostics module of a virtual reality hip arthroscopy simulator.MethodsA total of 25 orthopaedic surgeons, 7 faculty members and 18 orthopaedic residents, performed diagnostic supine hip arthroscopies of a healthy virtual reality hip joint using a 70° arthroscope. Twelve specific targets were visualised within the central compartment; six via the anterior portal, three via the anterolateral portal and three via the posterolateral portal. This task was immediately followed by a questionnaire regarding the realism and training capability of the system. This consisted of seven questions addressing the verisimilitude of the simulator and five questions addressing the training environment of the simulator. Each question consisted of a statement stem and 10-point Likert scale. Following similar work in surgical simulators, a rating of 7 or above was considered an acceptable level of realism.ResultsThe diagnostic hip arthroscopy module was found to have an acceptable level of realism in all domains apart from the tactile feedback received from the soft tissue. 23 out of 25 participants (92%) felt the simulator provided a non-threatening learning environment and 22 participants (88%) stated they enjoyed using the simulator. It was most frequently agreed that the level of trainees who would benefit most from the simulator were registrars and fellows (22 participants; 88%). Additionally, 21 of the participants (84%) agreed that this would be a beneficial training modality for foundation and core trainees, and 20 participants (80%) agreed that his would be beneficial for consultants.ConclusionsThis VR hip arthroscopy simulator was demonstrated to have a sufficient level of realism, thus establishing its face validity. These results suggest this simulator has sufficient realism for use in the acquisition of basic arthroscopic skills and supports its use in orthopaedics surgical training.Level of evidenceI.
Highlights
Over the last decade, there has been increasing investigation into the use of virtual reality (VR) simulation in surgical education [1]
Realism The external instrumentation was realistic The visual experience of arthroscopy was realistic The visual experience of the instruments on the screen was realistic The feel of the bone was realistic The feel of the soft tissue was realistic The arthroscopy procedure was realistic The steps performed in the simulator accurately reflected the steps taken during the actual procedure The simulator gave a sense of what arthroscopy would be like
These results mimic those of similar studies relating to the use of VR simulation in orthopaedic training and support this hip arthroscopy simulator’s use in helping trainees gain basic experience in hip arthroscopy [3, 8, 10, 13, 25, 30, 31]
Summary
There has been increasing investigation into the use of virtual reality (VR) simulation in surgical education [1]. Multiple studies have highlighted worse outcomes and increased operating time in arthroscopic operations performed by inexperienced surgeons, demonstrating higher incidences of chondral damage and perineal injuries in hip arthroscopies performed in the first 3 years of an arthroscopic surgeon’s training [9, 18, 21]. These increased complication rates and longer operating times mandate a strategy to overcome this initial learning curve. VR describes the computer-generated simulation of threedimensional environments that can be interacted with in a seemingly real or physical way Advances in this field have led to a rapid expansion in the number of commercially available surgical simulators, with more than 400 models
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