Computer-Simulation Training for Knee and Shoulder Arthroscopic Surgery

Modi, Chetan S.; Morris, Guy; Mukherjee, Ronan

doi:10.1016/j.arthro.2009.12.033

Cited by 66 publications

(50 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, technical skills should be easily evaluated and expertise differentiated on the simulated models. Various simulation models have been explored in orthopaedic training [19,21]; however, to our knowledge there have been no studies specifically comparing different surgical simulators in teaching arthroscopic skills or assessing surgical proficiency. The first step, and purpose of this study, is to validate the use of both virtual and benchtop models for differentiation of surgical proficiency in the same subjects.…”

Section: Discussionmentioning

confidence: 99%

Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Chang

Banaszek

Gambrel

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Work-hour restrictions and fatigue management strategies in surgical training programs continue to evolve in an effort to improve the learning environment and promote safer patient care. In response, training programs must reevaluate how various teaching modalities such as simulation can augment the development of surgical competence in trainees. For surgical simulators to be most useful, it is important to determine whether surgical proficiency can be reliably differentiated using them. To our knowledge, performance on both virtual and benchtop arthroscopy simulators has not been concurrently assessed in the same subjects. Questions/purposes (1) Do global rating scales and procedure time differentiate arthroscopic expertise in virtual and benchtop knee models? (2) Can commercially available built-in motion analysis metrics differentiate arthroscopic expertise? (3) How well are performance measures on virtual and benchtop simulators correlated? (4) Are these metrics sensitive enough to differentiate by year of training? Methods A cross-sectional study of 19 subjects (four medical students, 12 residents, and three staff) were recruited and divided into 11 novice arthroscopists (student to Postgraduate Year [PGY] 3) and eight proficient arthroscopists (PGY 4 to staff) who completed a diagnostic arthroscopy and loose-body retrieval in both virtual and benchtop knee models. Global rating scales (GRS), procedure times, and motion analysis metrics were used to evaluate performance. CI, seconds, p = 0.002). The built-in motion analysis metrics also distinguished novices from proficient arthroscopists using the self-generated virtual loose body retrieval task scores (4 ± 1 [95% CI, 3-5] versus 6 ± 1 [95% CI, 5-7], p = 0.001). GRS scores between virtual and benchtop models were very strongly correlated (q = 0.93, p \ 0.001). There was strong correlation between year of training and virtual GRS (q = 0.8, p \ 0.001) and benchtop GRS (q = 0.87, p \ 0.001) scores. Conclusions To our knowledge, this is the first study to evaluate performance on both virtual and benchtop knee simulators. We have shown that subjective GRS scores and objective motion analysis metrics and procedure time are valid measures to distinguish arthroscopic skill on both virtual and benchtop modalities. Performance on both modalities is well correlated. We believe that training on artificial models allows acquisition of skills in a safe environment. Future work should compare different modalities in the efficiency of skill acquisition, retention, and transferability to the operating room.123 Clin Orthop Relat Res (2016) 474:956-964 DOI 10.1007/s11999-015-4510-8 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® GRS scales. The proficient subjects completed nearly all tasks faster

show abstract

Section: Discussionmentioning

confidence: 99%

Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Chang

Banaszek

Gambrel

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Unfortunately, plastic models offer only reduced realism, while using cadavers implies high maintenance requirements and costs. Virtual-reality-based simulators have been explored for some time now as a possible alternative, also for arthroscopy simulators [11,20,32,34].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a virtual-reality-based simulator using passive haptic feedback for knee arthroscopy

Fucentese

Rahm

Wieser

et al. 2014

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PURPOSE The aim of this work is to determine face validity and construct validity of a new virtual-reality-based simulator for diagnostic and therapeutic knee arthroscopy. METHODS The study tests a novel arthroscopic simulator based on passive haptics. Sixty-eight participants were grouped into novices, intermediates, and experts. All participants completed two exercises. In order to establish face validity, all participants filled out a questionnaire concerning different aspects of simulator realism, training capacity, and different statements using a seven-point Likert scale (range 1-7). Construct validity was tested by comparing various simulator metric values between novices and experts. RESULTS Face validity could be established: overall realism was rated with a mean value of 5.5 points. Global training capacity scored a mean value of 5.9. Participants considered the simulator as useful for procedural training of diagnostic and therapeutic arthroscopy. In the foreign body removal exercise, experts were overall significantly faster in the whole procedure (6 min 24 s vs. 8 min 24 s, p < 0.001), took less time to complete the diagnostic tour (2 min 49 s vs. 3 min 32 s, p = 0.027), and had a shorter camera path length (186 vs. 246 cm, p = 0.006). CONCLUSION The simulator achieved high scores in terms of realism. It was regarded as a useful training tool, which is also capable of differentiating between varying levels of arthroscopic experience. Nevertheless, further improvements of the simulator especially in the field of therapeutic arthroscopy are desirable. In general, the findings support that virtual-realitybased simulation using passive haptics has the potential to complement conventional training of knee arthroscopy skills. LEVEL OF EVIDENCE: II. Abstract Purpose The aim of this work is to determine face validity and construct validity of a new virtual-reality-based simulator for diagnostic and therapeutic knee arthroscopy. Methods The study tests a novel arthroscopic simulator based on passive haptics. Sixty-eight participants were grouped into novices, intermediates, and experts. All participants completed two exercises. In order to establish face validity, all participants filled out a questionnaire concerning different aspects of simulator realism, training capacity, and different statements using a seven-point Likert scale (range 1-7). Construct validity was tested by comparing various simulator metric values between novices and experts. Results Face validity could be established: overall realism was rated with a mean value of 5.5 points. Global training capacity scored a mean value of 5.9. Participants considered the simulator as useful for procedural training of diagnostic and therapeutic arthroscopy. In the foreign body removal exercise, experts were overall significantly faster in the whole procedure (6 min 24 s vs. 8 min 24 s, p \ 0.001), took less time to complete the diagnostic tour (2 min 49 s vs. 3 min 32 s, p = 0.027), and had a shorter camera path length (186 vs. 246 cm, p = 0.0...

show abstract

“…8 Arthroscopy lends itself to simulation because it is easily reproducible, and simulation for arthroscopy training can take a number of forms. 9 It can be performed on a range of anatomic models, including those made from synthetic materials (e.g., plastic) or cadavers (human or animal). More recently, computer models have been used for simulation (virtual reality [VR]).…”

mentioning

confidence: 99%

“…More recently, computer models have been used for simulation (virtual reality [VR]). [9][10][11][12] Computer models are highly objective because they use internal metric calculations and are assessor independent. They have few ethical considerations but generally have been costly, require fixed training facilities, and need specialized technical support.…”

mentioning

confidence: 99%

Arthroscopic Skills Acquisition Tools: An Online Simulator for Arthroscopy Training

Gandhi

Anderton

Funk

2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Computer-Simulation Training for Knee and Shoulder Arthroscopic Surgery

Cited by 66 publications

References 6 publications

Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Global Rating Scales and Motion Analysis Are Valid Proficiency Metrics in Virtual and Benchtop Knee Arthroscopy Simulators

Evaluation of a virtual-reality-based simulator using passive haptic feedback for knee arthroscopy

Arthroscopic Skills Acquisition Tools: An Online Simulator for Arthroscopy Training

Contact Info

Product

Resources

About