Arthroscopic Shoulder Surgical Simulation Training Curriculum: Transfer Reliability and Maintenance of Skill Over Time

Dunn, John C.; Belmont, Philip J.; Lanzi, Joseph T.; Martin, Kevin D.; Bader, Julia M.; Owens, Brett D.; Waterman, Brian R.

doi:10.1016/j.jsurg.2015.06.021

Cited by 60 publications

(56 citation statements)

References 29 publications

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“…Previous investigations of simulator training have shown transfer validity of skills between simulator models, 7,17 cadaveric models, 6,8,11,12,14,15,17 and live arthroscopy, 10,13,16 whereas 2 studies found no direct transfer validity between simulator models. 19,20 A recent systematic review and meta-analysis of studies investigating the impact of simulator training on performance showed a strong effect on simulator performance and a moderate effect on human-model (live or cadaveric) performance.…”

Section: Discussionmentioning

confidence: 94%

“…In fact, some studies have used a total simulator exposure time of 1 hour as a simulator training curriculum. 11,16,19 Thus, although it was not our intent on study design, this study may be better classified as a trial of "trained" versus "over-trained" subjects as opposed to "trained" versus "untrained." Because of the lack of a true, simulator-naive control group, the interpretation of our results must be made with caution.…”

Section: Limitationsmentioning

confidence: 99%

“…5,6 Previous investigations have generally supported some degree of skill transfer from practice on arthroscopic simulator models to performance on either cadaveric models or live arthroscopy. [7][8][9][10][11][12][13][14][15][16][17][18] However, some investigations have challenged the idea that simulator training provides generalizable skill acquisition. 19,20 In addition, the questions of how much simulator training is necessary and if there is an upper limit to the benefits of simulator training hold particular importance as new simulator technologies are being integrated into residency training programs.…”

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confidence: 99%

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Impact of Simulation Training on Diagnostic Arthroscopy Performance: A Randomized Controlled Trial

Wang

Bernardoni

Cotter

et al. 2019

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose:To determine the impact of training on a virtual reality arthroscopy simulator on both simulator and cadaveric performance in novice trainees. Methods: A randomized controlled trial of 28 participants without prior arthroscopic experience was conducted. All participants received a demonstration of how to use the ArthroVision Virtual Reality Simulator and were then randomized to receive either no training (control group, n ¼ 14) or a fixed protocol of simulation training (n ¼ 14). All participants took a pretest on the simulator, completing 9 tasks ranging from camera-steadying tasks to probing structures. The training group then trained on the simulator (1 time per week for 3 weeks). At week 4, all participants completed a 2-part post-test, including (1) performing all tasks on the simulator and (2) performing a diagnostic arthroscopy on a cadaveric knee and shoulder. An independent, blinded observer assessed the performance on diagnostic arthroscopy using the Arthroscopic Surgical Skill Evaluation Tool scale. To compare differences between nonenormally distributed groups, the Mann-Whitney U test was used. An independent-samples t test was used for normally distributed groups. The Friedman test with pair-wise comparisons using Bonferroni correction was used to compare scores within groups at multiple time points. Bonferroni adjustment was applied as a multiplier to the P value; thus, the a level remained consistent. Significance was defined as P < .05. Results: In both groups, all tasks except task 5 (in which completion time was relatively fixed) showed a significant degree of correlation between task completion time and other task-specific metrics. A significant difference between the trained and control groups was found for post-test task completion time scores for all tasks. Qualitative analysis of box plots showed minimal change after 3 trials for most tasks in the training group. There was no statistical correlation between the performance on diagnostic arthroscopy on either the knee or shoulder and simulation training, with no difference in Arthroscopic Surgical Skill Evaluation Tool scores in the training group compared with controls. Conclusions: Our study suggests that an early ceiling effect is shown on the evaluated arthroscopic simulator model and that additional training past the point of proficiency on modern arthroscopic simulator models does not provide additional transferable benefits on a cadaveric model. Level of Evidence: Level I, randomized controlled trial.G raduate medical education, specifically surgical education, has traditionally been rooted in an apprenticeship model. The "see one, do one, teach one" approach has guided education in the operating room and has led to the development of surgical education as it stands today. However, there are rising concerns regarding burnoutda condition correlated with longer work hours, a skewed work-life balance, and

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Section: Discussionmentioning

confidence: 94%

Section: Limitationsmentioning

confidence: 99%

mentioning

confidence: 99%

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Impact of Simulation Training on Diagnostic Arthroscopy Performance: A Randomized Controlled Trial

Wang

Bernardoni

Cotter

et al. 2019

Arthroscopy, Sports Medicine, and Rehabilitation

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“…7 Recent studies have shown that surgical simulation training can improve performance, and longitudinal integration of skills training should continue throughout a training program. 8,20,30 conclusion Resident knowledge of shoulder instability and simulated performance of an arthroscopy-assisted stabilization improved following a structured intervention. Our data…”

Section: Limitationsmentioning

confidence: 97%

Teaching simulated arthroscopic Bankart repair: residents’ assessment at the Annual Shoulder Course

Rouleau

Bedard

Canet

et al. 2019

cjs

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Background: This study's aim was to evaluate the performance of senior orthopedic residents during simulated arthroscopic anterior stabilization (Bankart repair) before and after a national shoulder review course.Methods: Participants were assessed before and after the Annual Shoulder Review Course over a 3-day period, using a multiple-choice examination and surgery perform ance assessment. The surgical evaluation was completed by fellowship-trained surgeons using a standardized procedure checklist and a global rating scale. All Canadian senior orthopedic residents were invited to participate in the course. Results:The 57 participants showed improvement following the course. The written knowledge evaluation mean score increased, and all 3 surgical performance measurements improved: surgical task time improved from 4:40 min to 2:53 min (p < 0.001), surgical technique evaluation increased from 56% to 67% after the procedure checklist (p < 0.001), and anchor placement improved for all 3 aspects. Anchor entry point was the sole measure not to improve enough to reach statistical significance (p = 0.37). Conclusion:Our data support the inclusion of dry model surgical simulation as part of a surgical skills course for both training and assessment of orthopedic surgery residents.Contexte : Le but de cette étude était d'évaluer le rendement des résidents seniors en orthopédie durant une simulation de stabilisation arthroscopique antérieure (intervention de Bankart) avant et après un cours de révision national sur l'articulation de l'épaule. Méthodes : Les participants ont été évalués avant et après l'Annual Shoulder ReviewCourse sur une période de 3 jours, à l'aide d'un examen à choix multiples et d'une épreuve chirurgicale pratique. L'évaluation chirurgicale était effectuée par des chirurgiens spécialisés, à l'aide d'une liste de vérification normalisée des procédures et d'une échelle d'évaluation globale. Tous les résidents séniors canadiens en orthopédie étaient invités à participer au cours.

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“…Surgical simulation training has been proposed as a means to counter any erosion of surgical resident education that might occur due to work hour constraints that limit the exposure of residents to the operating room. 5 Virtual surgical simulation programs for the education of surgical residents were first proposed over 20 years ago as a method to gain exposure to "reallife" training necessary to provide an optimum level of patient care. 16 Virtual surgical simulation programs can be defined as the surgical training of individuals utilizing prosthetic anatomical models or digital recreation of an procedure using a computer.…”

Section: Introductionmentioning

confidence: 99%

Wearable Inertial Sensors Allow for Quantitative Assessment of Arthroscopic Skill in a Cadaveric Shoulder Model

Schreiner¹

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Arthroscopic Shoulder Surgical Simulation Training Curriculum: Transfer Reliability and Maintenance of Skill Over Time

Cited by 60 publications

References 29 publications

Impact of Simulation Training on Diagnostic Arthroscopy Performance: A Randomized Controlled Trial

Impact of Simulation Training on Diagnostic Arthroscopy Performance: A Randomized Controlled Trial

Teaching simulated arthroscopic Bankart repair: residents’ assessment at the Annual Shoulder Course

Wearable Inertial Sensors Allow for Quantitative Assessment of Arthroscopic Skill in a Cadaveric Shoulder Model

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