Development of a physical shoulder simulator for the training of basic arthroscopic skills

McCracken, Laura C.; Trejos, Ana Luisa; LeBel, Marie‐Eve; Poursartip, Behnaz; Escoto, Abelardo; Patel, Rajni V.; Naish, Michael D.

doi:10.1002/rcs.1868

Cited by 6 publications

(3 citation statements)

References 17 publications

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“…Questionnaire results from AR group participants on their training experience , scored from 0 (completely disagree) to 10 (completely agree) envision the use of this platform as an adjunct to receiving teaching from an expert surgeon and not a replacement. This preference for blended implementation of AR training is common with other studies of virtual reality simulators [13,18,31] and curricula which integrate simulators into orthopaedic residency [40]. In this small, randomized, controlled simulation trial comparing training from augmented reality platform with an expert surgeon, novices learned to orient an acetabular cup to the same level of accuracy.…”

Section: Discussionmentioning

confidence: 95%

Can an Augmented Reality Headset Improve Accuracy of Acetabular Cup Orientation in Simulated THA? A Randomized Trial

Logishetty

Western

Morgan

et al. 2018

Clin Orthop Relat Res

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Background Accurate implant orientation reduces wear and increases stability in arthroplasty but is a technically demanding skill. Augmented reality (AR) headsets overlay digital information on top of the real world. We have developed an enhanced AR headset capable of tracking bony anatomy in relation to an implant, but it has not yet been assessed for its suitability as a training tool for implant orientation. Questions/purposes (1) In the setting of simulated THA performed by novices, does an AR headset improve the accuracy of acetabular component positioning compared with hands-on training by an expert surgeon? (2) What are trainees' perceptions of the AR headset in terms of realism of the task, acceptability of the technology, and its potential role for surgical training? Methods Twenty-four study participants (medical students in their final year of school, who were applying to surgery residency programs, and who had no prior arthroplasty experience) participated in a randomized simulation trial using an AR headset and a simulated THA. Participants were randomized to two groups completing four once-weekly sessions of baseline assessment, training, and reassessment. One group trained using AR (with live holographic orientation feedback) and the other received one-on-one training from a hip arthroplasty surgeon. Demographics and baseline performance in orienting an acetabular implant to six patient-specific values on the phantom pelvis were collected before training and were comparable. The orientation error in degrees between the planned and achieved orientations was measured and was not different between groups with the numbers available (surgeon group mean error 6 SD 16°6 7°versus AR 14°6 7°; p = 0.22). Participants trained by AR also completed a validated posttraining questionnaire evaluating their experiences. Results During the four training sessions, participants using AR-guidance had smaller mean (6 SD) errors in orientation than those receiving guidance from the surgeon: 1°6 1°versus AR 6°6 4°, p < 0.001. In the fourth session's assessment, participants in both groups had improved (surgeon group mean improvement 6°, 95% CI, 4-8°; p < 0.001 versus AR group 9°, 95% CI 7-10°; p < 0.001). There was no difference between participants in the surgeon-trained and AR-trained group: mean difference 1.2°, 95% CI,-1.8 to 4.2°; p = 0.281. In posttraining evaluation, 11 of 12 participants would use the AR One of the authors (FI) received funding from Orthopaedic Research UK (31434). One of the authors (KL) received funding from the Royal College of Surgeons of England (P67699). Clinical Orthopaedics and Related Research® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDAapproval status, of any drug or device prior to clinical use. Each author certifies that his institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research. Al...

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Section: Discussionmentioning

confidence: 95%

Can an Augmented Reality Headset Improve Accuracy of Acetabular Cup Orientation in Simulated THA? A Randomized Trial

Logishetty

Western

Morgan

et al. 2018

Clin Orthop Relat Res

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“…A sensorized physical shoulder simulator was used in this study for investigating three arthroscopic tasks: two probing tasks and a grasping task. The shoulder simulator was developed at Canadian Surgical Technologies and Advanced Robotics (CSTAR), and its face and construct validity were demonstrated in [ 21 ]. The simulator and the accompanying video tower are shown in Figure 1 a.…”

Section: Methodsmentioning

confidence: 99%

Energy-Based Metrics for Arthroscopic Skills Assessment

Poursartip

LeBel

McCracken³

et al. 2017

Sensors

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Abstract:Minimally invasive skills assessment methods are essential in developing efficient surgical simulators and implementing consistent skills evaluation. Although numerous methods have been investigated in the literature, there is still a need to further improve the accuracy of surgical skills assessment. Energy expenditure can be an indication of motor skills proficiency. The goals of this study are to develop objective metrics based on energy expenditure, normalize these metrics, and investigate classifying trainees using these metrics. To this end, different forms of energy consisting of mechanical energy and work were considered and their values were divided by the related value of an ideal performance to develop normalized metrics. These metrics were used as inputs for various machine learning algorithms including support vector machines (SVM) and neural networks (NNs) for classification. The accuracy of the combination of the normalized energy-based metrics with these classifiers was evaluated through a leave-one-subject-out cross-validation. The proposed method was validated using 26 subjects at two experience levels (novices and experts) in three arthroscopic tasks. The results showed that there are statistically significant differences between novices and experts for almost all of the normalized energy-based metrics. The accuracy of classification using SVM and NN methods was between 70% and 95% for the various tasks. The results show that the normalized energy-based metrics and their combination with SVM and NN classifiers are capable of providing accurate classification of trainees. The assessment method proposed in this study can enhance surgical training by providing appropriate feedback to trainees about their level of expertise and can be used in the evaluation of proficiency.

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“…Today, the use of training simulation systems is basically a substitute for traditional education methods and an effective way for residents training, like physical models or cadavers of animals or humans . An important point in a developed educational system is the less need for the trainer presence.…”

Section: Introductionmentioning

confidence: 99%

A validation study of a virtual‐based haptic system for endoscopic sinus surgery training

Sadeghnejad

Khadivar

Abdollahi

et al. 2019

Robotics Computer Surgery

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Background:The development of endoscopic sinus surgery (ESS) training simulators for clinical environment applications has reduced the existing shortcomings in conventional teaching methods, creating a standard environment for trainers and trainees in a more accurate and repeatable fashion. Materials and methods:In this research, the validation study of an ESS training simulator has been addressed. It is important to consider components that guide trainees to improve their hand movements control in the orbital floor removal in an ESS operation. Therefore, we defined three tasks to perform: pre-experiment learning, training, and evaluation. In these tasks, the critical regions introduced in the virtual training environment are forbidden to be touched. Recruiting 20 participants, divided into two groups, we investigated the performance metrics: quality (the percentage of the realism for the generated force for orbital floor removal and the usefulness of the proposed training system for the surgical educational curricula.), efficiency (time, path length), and safety (touching the goal and forbidden wall). Results:All recruited participants answered a post-evaluation questionnaire regarding their perceptions of training system realism, potential educational benefits, and practiced skills. We investigate the differences between groups' performance metrics by utilizing the analysis of variance-Kruskal-Wallis test. Acquired results indicate that training before the actual process of the surgery has a significant effect on the accuracy and validity of the process for surgeons. Conclusions:Utilizing a standardized environment, trainers and trainees are able to carry out a process with regular features. In addition to traditional education methods, trainees can learn the risk of surgical operations. The training simulators can, also, provide a standard method for assessing the skills of surgical and medical students.

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Development of a physical shoulder simulator for the training of basic arthroscopic skills

Abstract: Background: Orthopaedic training programs are incorporating arthroscopic simulations into

Cited by 6 publications

References 17 publications

Can an Augmented Reality Headset Improve Accuracy of Acetabular Cup Orientation in Simulated THA? A Randomized Trial

Can an Augmented Reality Headset Improve Accuracy of Acetabular Cup Orientation in Simulated THA? A Randomized Trial

Energy-Based Metrics for Arthroscopic Skills Assessment

A validation study of a virtual‐based haptic system for endoscopic sinus surgery training

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