Development of simulated arthroscopic skills

Andersen, Christine; Winding, Trine Nøhr; Vesterby, Martin

doi:10.3109/17453674.2011.552776

Cited by 40 publications

(41 citation statements)

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“…2A-B Built-in motion analysis metrics from the virtual simulator were able to distinguish novice and proficient arthroscopists by overall scores and economy of motion, but not in care with soft tissues. The novice group had lower overall scores in the virtual scope (3 ± 2 [95% CI, 2-4] versus 5 ± 3 [95% CI, [3][4][5][6][7][8], p = 0.018), virtual probe (5 ± 2 [95% CI, 3-6] versus 7 ± 1 [95% CI, 6-8], p = 0.009), and virtual loose-body tasks (4 ± 1 [95% CI, 3-5] versus 6 ± 1 [95% CI, [5][6][7], p = 0.001) (Fig. 3A-B Performance on virtual and benchtop models showed strong correlation based on subjective GRS scores and objective motion analysis metrics, suggesting that subjects performed similarly on both models.…”

Section: Resultsmentioning

confidence: 99%

“…In orthopaedic surgery, training on various virtual reality and benchtop simulators has been shown to improve performance based on motion analysis measures such as economy of motion and care with soft tissues in knee and shoulder arthroscopy [5,6]. Additionally, multiple studies have shown that motion analysis and global rating scales were able to differentiate arthroscopic proficiency in knee and shoulder models and cadavers based on years of residency training [5,11,13,15,16,22,28,29].…”

Section: Introductionmentioning

confidence: 99%

“…The proficient subjects completed nearly all tasks faster than novice subjects, including the virtual scope (579 ±169 [95% CI, 466-692] versus 358 ± 178 [95% CI, 210-507] seconds, p = 0.02) and benchtop knee scope + probe (480 ± 160 [95% CI, 373-588] versus 277 ± 64 [95% CI, 224-330] 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][6][7], p = 0.001). GRS scores between virtual and benchtop models were very strongly correlated (q = 0.93, p \ 0.001).…”

mentioning

confidence: 99%

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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

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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

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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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

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“…6 Appropriate modules not only can differentiate expertise levels (construct validity) but also are effective at improving arthroscopic skills in inexperienced surgeons. 9 Andersen et al 9 showed that those who were allowed to train on the simulator between a pre-and post-test performed better than those who did not, suggesting that repetition facilitates skill development.…”

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confidence: 98%

Fundamental Arthroscopic Skill Differentiation With Virtual Reality Simulation

Rose¹,

Pedowitz²

2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Los simuladores ofrecen una opción segura, ética y eficiente de entrenamiento en habilidades quirúrgicas, tanto básicas como complejas. [13][14][15][16] Los simuladores quirúrgicos, de acuerdo con sus características y propósitos, se clasifican en mecánicos y virtuales. 17 Si bien los simuladores virtuales ofrecen mayores ventajas en lo referente a la fidelidad anatómica y a la posibilidad de obtener estructuras con patologías especí-ficas, 6,18,19 el alto costo aún limita su uso.…”

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Desarrollo de un simulador de bajo costo para la adquisición de destrezas básicas en cirugía artroscópica

Cuéllar¹,

Cogua²,

García³

et al. 2014

Rev. Asoc. Arg. Ort. y Traumatol

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<div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><strong>Introducción: </strong><span>El propósito del estudio fue desarrollar, bajo parámetros de expertos y evaluación de idoneidad por el usuario final, un simulador mecánico de bajo costo, que permita desarrollar destrezas básicas, pero fundamentales, en el aprendizaje de la artroscopia. </span></p><p><strong>Materiales y Métodos: </strong><span>El trabajo se dividió en tres fases; en la primera, se encuestaron expertos y se establecieron criterios para el desarrollo del simulador artroscópico. Luego, se desarrolló el prototipo del simulador usando, además de los criterios mencionados, las características del instrumental y los objetivos de cada ejercicio planteado. Por último, se llevaron a cabo pruebas, usando el simulador final, con ortopedistas que realizaron el entrenamiento.</span></p><p><strong>Resultados: </strong><span>Se obtuvieron algunos criterios de importancia para el desarrollo del simulador, que se emplearon en el desarrollo del modelo final, cuyo costo estuvo por debajo de los 300 dólares estadounidenses. En cuanto a la aplicación práctica, se obtuvo una satisfacción del 100% y una idoneidad del 97,4% por parte de los ortopedistas que realizaron el entrenamiento.</span></p><p><strong>Conclusiones: </strong><span>Desarrollar procesos de entrenamiento es una labor fundamental de los centros de aprendizaje quirúrgico. El simulador ArtroCLEMI II probó ser una herramienta útil en el desarrollo de destrezas básicas de artroscopia, con costos mínimos y alta versatilidad. Es necesario fortalecer los procesos curriculares aplicados a las curvas de aprendizaje quirúrgico. </span></p><div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p> </p></div></div></div></div></div></div>

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Development of simulated arthroscopic skills

Cited by 40 publications

References 12 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

Fundamental Arthroscopic Skill Differentiation With Virtual Reality Simulation

Desarrollo de un simulador de bajo costo para la adquisición de destrezas básicas en cirugía artroscópica

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