A Prospective Assessment of Knee Arthroscopy Skills Between Medical Students and Residents—Simulator Exercises for Partial Meniscectomy and Analysis of Learning Curves

Abstract

Background The Covid-19 pandemic has created the largest disruption of education in history. In a response to this, we aimed to evaluate the knee arthroscopy learning curve among medical students and orthopaedic residents. Methods An arthroscopy simulator was used to compare the learning curves of two groups. Medical students with any prior knowledge of arthroscopy ( n=24) were compared to a residents group ( n=16). Analyzed parameters were “time to complete a task,” assessment of the movement of tools and values scoring damage to the surrounding tissues. Results After several repetitions, both groups improved their skills in terms of time and movement. Residents were on average faster, had less camera movement, and touched the cartilage tissue less often than did students. Students showed a steeper improvement curve than residents for certain parameters, as they started from a different experience level. Conclusion The participants were able to reduce the time to complete a task. There was also a decrease in possible damage to the virtual surrounding tissues. In general, the residents had better mean values, but the students had the steeper learning curve. Particularly less experienced surgeons can especially train their hand–eye coordination skills required for arthroscopy surgery. Training simulators are an important training tool that supplements cadaveric training and participation in arthroscopic operations and should be included in training.

Orthopaedic Surgery Training and Education During COVID-19

“…Furthermore, 1 study even found VR simulation to be as effective as cadaver training, and residents rated VR education as comparable in effectiveness to surgical experiences, although further research is required to determine the applicability and usage of VR 86 . By contrast, more traditional physical surgical simulators showed learner improvement in arthroscopy skills 87 . Other technologies such as 3D-printed lumbar spines showed feasibility to practice pedicle screw placement in an affordable and remote manner 88 .…”

“…These findings suggest a balance may need to be struck between inperson and online education. Finally, the utility of VR and simulations was recognized and accelerated as a result of the pandemic for socially distanced surgical training; future directions will focus on augmenting long-term skill retention and transferability [85][86][87]90 . By providing a safe, controlled, and customizable environment for skill development, these technologies can accelerate learning, promote interdisciplinary collaboration, and improve overall surgical competence, ultimately benefiting both trainees and patients.…”

CORR Synthesis: How Have Film Review and Motion Analysis Been Used to Enhance Orthopaedic Surgical Performance?

“…This study revealed that blinded graders from other institutions are best for grading maximum depth applied to damageable tissues by a tool in the simulation. Although tool-distance-traveled metrics differentiated between trainees with different skill levels performing diagnostic knee arthroscopy, loose body retrievals, and partial meniscectomies on a virtual reality arthroscopy simulator [17,18,72], the roughness parameter was not different between trainees with different experience levels [17,72]. In other studies, neither tool distance traveled nor damage to tissues were reliable metrics in differentiating users by experience level during diagnostic virtual reality hip arthroscopy and loose body removal [13], as well as during virtual reality arthroscopic ACL reconstruction [7].…”

“…After full-text review, we included 27 studies investigating the use of film review in orthopaedics including five randomized controlled trials [8, 9, 21, 36, 47] and 22 observational studies [3, 11, 12, 15, 20, 23, 24, 30, 41, 44, 50-52, 56, 61, 64, 65, 69, 77, 78, 81, 82]. We included 28 studies investigating the use of motion analysis in orthopaedics, including four randomized controlled trials [40, 58, 62, 70] and 24 observational studies [2, 7, 13, 14, 17, 18, 32, 38, 39, 43, 49, 57, 63, 67, 68, 71-73, 75, 76, 83, 84, 89, 90].…”

A spaced retraining schedule with 2‐day interval improves the acquisition and retention of simulation‐based basic arthroscopic skills

“…Arthroscopic methods are rapidly developing, and residents are being required to master increasingly complex surgical skills in a shorter period [2]. Thus, it is important to consider the steep learning curve of this specialty [16][17][18][19][20][21]. In recent years, simulation training has been used in other surgical areas, and studies have shown that practising surgical skills using a proven simulator can effectively shorten the learning curve [20].…”