Current Status of Simulation-based Training Tools in Orthopedic Surgery: A Systematic Review

Morgan, Michael J.; Aydın, Abdullatif; Salih, A Jabbar Mahdi; Robati, Shibby; Ahmed, Kamran

doi:10.1016/j.jsurg.2017.01.005

Cited by 69 publications

(52 citation statements)

References 90 publications

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“…Orthopaedic simulation has generally lagged behind other specialties, with fewer validated simulators available; this trend is now changing and recent studies support the notion that orthopaedic simulators have the potential to translate useful technical skills into the operating theatre [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

How to Build a Patient-Specific Hybrid Simulator for Orthopaedic Open Surgery: Benefits and Limits of Mixed-Reality Using the Microsoft HoloLens

Condino

Turini

Parchi

et al. 2018

Journal of Healthcare Engineering

109

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Orthopaedic simulators are popular in innovative surgical training programs, where trainees gain procedural experience in a safe and controlled environment. Recent studies suggest that an ideal simulator should combine haptic, visual, and audio technology to create an immersive training environment. This article explores the potentialities of mixed-reality using the HoloLens to develop a hybrid training system for orthopaedic open surgery. Hip arthroplasty, one of the most common orthopaedic procedures, was chosen as a benchmark to evaluate the proposed system. Patient-specific anatomical 3D models were extracted from a patient computed tomography to implement the virtual content and to fabricate the physical components of the simulator. Rapid prototyping was used to create synthetic bones. The Vuforia SDK was utilized to register virtual and physical contents. The Unity3D game engine was employed to develop the software allowing interactions with the virtual content using head movements, gestures, and voice commands. Quantitative tests were performed to estimate the accuracy of the system by evaluating the perceived position of augmented reality targets. Mean and maximum errors matched the requirements of the target application. Qualitative tests were carried out to evaluate workload and usability of the HoloLens for our orthopaedic simulator, considering visual and audio perception and interaction and ergonomics issues. The perceived overall workload was low, and the self-assessed performance was considered satisfactory. Visual and audio perception and gesture and voice interactions obtained a positive feedback. Postural discomfort and visual fatigue obtained a nonnegative evaluation for a simulation session of 40 minutes. These results encourage using mixed-reality to implement a hybrid simulator for orthopaedic open surgery. An optimal design of the simulation tasks and equipment setup is required to minimize the user discomfort. Future works will include Face Validity, Content Validity, and Construct Validity to complete the assessment of the hip arthroplasty simulator.

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Section: Introductionmentioning

confidence: 99%

How to Build a Patient-Specific Hybrid Simulator for Orthopaedic Open Surgery: Benefits and Limits of Mixed-Reality Using the Microsoft HoloLens

Condino

Turini

Parchi

et al. 2018

Journal of Healthcare Engineering

109

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“…VR simulators can provide instant feedback of various performance metrics and highlighting certain elements of the trainees’ performance has been shown by numerous groups to improve simulator performances with time. 23–26…”

Section: Discussionmentioning

confidence: 99%

Survey of trainee attitudes to skill development and simulation training in trauma and orthopaedics

Jassim

Varma

Ramachandran

et al. 2020

BMJ Simul Technol Enhanc Learn

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BackgroundSimulation training in surgery is widespread and allows surgeons to practise novel operative techniques and acquaint themselves with unfamiliar surgical procedures. The use of box or virtual reality simulators in many surgical specialities is established; however, its use within trauma and orthopaedics (T&O) in the UK and the attitudes of trainee towards it are not known. The aim of this study is to explore the experiences and opinions of T&O trainees towards simulation training.MethodsAn electronic survey consisting of 11 questions on the experiences of simulation training and attitudes towards it was sent to all T&O speciality trainees in London.ResultsFewer than 10% of the responders had used or had ready access to simulators to prepare for unfamiliar operations, with almost 90% preferring to read about them in a journal or watch them on an online video site. Over half had only seen simulators on courses or been aware of them. Over 75% of the responders believed that simulators should be available for trainees, but most did not feel that they should be used as part of formal assessments.ConclusionsMethods for preparing for new operations have expanded over the past 20 years, yet the use of simulator machines is not widespread. Many trainees believe current machines are not widely available nor realistic enough to be useful, with most preferring online videos and operative technique books for preparing for an unfamiliar operation.

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“…For this reason, institutions and areas such as orthopedics, which understand the need to implement the simulation in their curriculum program design their own simulators, as is the case of arthroscopy simulators and virtual reality programs; however, they must be validated to demonstrate that their design and applicability recreate situations similar to the real ones and that the appropriate process of meaningful learning takes place. [13][14][15][16][17][18][19] Another use of clinical simulation within the orthopedic area is to classify the level of competence of different procedures performed by physicians through performance metrics that precisely define the performance threshold, opening the possibility of using the simulation to evaluate or certifying the level of competence. 20,21 These are lots of simulation approaches in orthopedics; although it is known that orthopedic education in the postgraduate area has great relevance, within the area of undergraduate general medical training is limited, and the evidence found regarding competencies in orthopedics, existing reports show that they lack the skills needed to diagnose, treat or to refer to the specialist.…”

Section: Discussionmentioning

confidence: 99%

The simulation in health care in orthopedics

Sánchez¹,

Cortés²,

López³

et al. 2019

MOJOR

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The changes in education, secondary to the demand for health care in the 21 st century, have exploited different strategies to improve the quality of training of health professionals, simulation in health care has had a boom in recent decades and the branch of Orthopedics has not been exempt. There are different approaches that can be reached with simulation in orthopedics, from simulation management and simulators or virtual reality programs to influence the learning curve and improve technical and non-technical skills, classify the level of those skills, assess and certify professional competencies, among others. Most studies in orthopedics focus on surgical areas, leaving aside the approach of clinical and non-technical skills, as well as undergraduate, so one of the challenges of simulation within the area of orthopedics is to expand the vision towards these areas, since it has been demonstrated that at all levels, the simulation generates significant improvements in the training and performance of health personnel, generating a direct impact on patient safety.

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Current Status of Simulation-based Training Tools in Orthopedic Surgery: A Systematic Review

Cited by 69 publications

References 90 publications

How to Build a Patient-Specific Hybrid Simulator for Orthopaedic Open Surgery: Benefits and Limits of Mixed-Reality Using the Microsoft HoloLens

How to Build a Patient-Specific Hybrid Simulator for Orthopaedic Open Surgery: Benefits and Limits of Mixed-Reality Using the Microsoft HoloLens

Survey of trainee attitudes to skill development and simulation training in trauma and orthopaedics

The simulation in health care in orthopedics

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