Knee, Shoulder, and Fundamentals of Arthroscopic Surgery Training: Validation of a Virtual Arthroscopy Simulator

Editorial Commentary: Taking the Time to Teach the Next Generation of Orthopaedic Sports Medicine Physicians

“…Although resident-based education for arthroscopic procedures is transitioning to proficiency-based training, [2][3][4] there is still an apprenticeship component in which junior residents spend much of their time observing arthroscopic procedures while improving their motor skills on simulators and cadavers until they have obtained the skill set and trust of their attendings to actively participate in operative procedures. 5 Because senior residents are still novices compared with attending sports medicine surgeons, [6][7][8][9] it makes sense that resident-involved procedures take longer than attending-only procedures as the resident performs increasing portions of the case. Moreover, given that Beletsky et al 1 calculated opportunity cost as inversely proportional to time, the longer the case, the larger the opportunity cost.…”

Proficiency-Based Training Using Simulator-Based Tools Could be Validated for Certification of Surgical Procedural Proficiency

“…Other authors have confirmed Angelo et al's findings. [11][12][13][14] In sum, studies suggest that competencybased simulator training may serve to advance arthroscopic skills for residents, PBT is superior to the traditional apprenticeship model of surgical training, and PBT-based evaluation can be used to evaluate a surgeon's proficiency in performing a specific surgical procedure. Theoretically, these methods could be used to certify that surgeons possess, and maintain, adequate hands-on skills required to perform surgery safely, efficiently, and with adequate competence.…”

Arthroscopic Training in the 21st Century: A Changing Paradigm

“…12,13 Once a model is deemed reproducible, it then needs to be validated. [14][15][16] Using an Alex shoulder model as a simulator, and then a cadaveric model, Angelo, Ryu, Pedowitz, Gallagher, and other AANA leaders and scholars compellingly identified reproducible and measurable steps representing proficiency in performing an arthroscopic Bankart repair. 17,18 This was the AANA Copernicus Initiative, and as a result, PBP training, rather than classical apprenticeship training, is developing as the avowed new center of our arthroscopic training solar system.…”

“…Rather, the first day of the 3-day Resident Course is spent in a dry lab, where residents learn and perform basic arthroscopic tasks at knot-tying stations, Fundamentals of Arthroscopic Surgery Training (FAST) workstations, [19][20][21] and computerized arthroscopy simulators. 4,7,10,16 In the experience of our first author and frequent AANA OLC Resident Course Co-Chair, Michael Feldman, M.D., Resident Course participants would historically be frustrated because they attempted to perform complicated procedures before mastering the basics. For example, in a shoulder lab, a perfectly placed Bankart anchor would be wasted if the trainee went on to tie an "air knot."…”