Transfer of arthroscopic skills from computer simulation training to the operating theatre: a review of evidence from two randomised controlled studies

Abstract

Introduction: There is paucity in the research on transfer validity of arthroscopic simulator training. The aim of this article is to determine whether skills derived from arthroscopic simulation are transferrable to the operating theatre and retained over time. Methods: A systematic review with rigorous criteria to identify the highest level of evidence available was carried out. The studies were critically appraised with narrative data synthesis. Results: Twenty-one studies on arthroscopic simulation were identified. Only two studies were randomised controlled trials. The first article demonstrated improved performance of basic knee arthroscopic tasks following a fixed period of training. The second article showed improved performance of arthroscopic tasks and no deterioration in the levels of skills following a period of six months. In addition, the two studies succeeded in demonstrating the importance of 3D motion analysis using computer simulators in the assessment of technical skills. Components of evaluation such as time to task completion, distance travelled by instruments and incidence of instruments collisions were associated with the highest validity and reliability of assessment. This systematic review highlighted the limitations of these two randomised studies. Discussion: Evidence from the two trials suggests that knee arthroscopy simulator training can result in improved performance. This review helped highlight the contribution of the two studies in terms of internal validity and consistency of using arthroscopic skills training. Further level I studies are however required to demonstrate the evidence for transfer and predictive validity of computer simulation as a training instrument.

Acquisition of Practical Skills in Domestic Electrical Installation: Computer Simulation Versus Demonstration Approach

“…The result is also consistent with the findings of Ezeudu and Ezinwanne (2013) that the achievement of students in chemistry increased after being taught with computer simulation. Furthermore, the result of the study is consistent with the results of Boutefnouchet and Laios (2016) and Guy and Lownes-Jackson (2015). On the contrary, this result negates the result obtained by Bayrak (2007) who found that there was no significant difference in the effectiveness of using computer simulated and laboratory instructions.…”

“…In a critical review study conducted by Boutefnouchet and Laios (2016) to determine the transferability and retention of skills learned from arthroscopic simulation to operating theatre, it was found that the simulation was successful in improving performance of basic tasks. Guy and Lownes-Jackson (2015) carried out an experimental study to compare the effect of computer simulation and the traditional instructional method on students' achievement in microcomputer application course.…”

Teaching and proficiency assessment for arthroscopy in veterinary surgery: A 2017 survey of diplomates and residents of the American and European College of Veterinary Surgeons

“…A simulation program can complement traditional supervised clinical training by permitting acquisition of technical skills in a low stakes environment, reducing the number of clinical cases required for proficiency . Although simulators allow for teaching and assessment of technical skills, whether this actually translates to improved proficiency in the operating room (transfer validity) has yet to be determined . Investment in simulation programs, however, has been shown to result in cost savings due to shorter operating times and reduced patient morbidity …”

Arthroscopic skills assessment and use of box model for training in arthroscopic surgery using Sawbones – “FAST” workstation

“…Cadavers and computerized high fidelity simulators which incorporate three-dimensional anatomy, virtual reality, haptic feedback, trajectory and force data analysis are useful in providing a training atmosphere which attempts to recreate anatomy, tissue response and clinical scenarios [2, 4, 7–9, 12–17, 21, 22, 26, 27, 33, 34]. Recent evidence also suggests that there is considerable ability to transfer skills acquired on simulators to the operating room [34].…”

“…Recent evidence also suggests that there is considerable ability to transfer skills acquired on simulators to the operating room [34]. However, both cadaveric and high technology computerized simulators are limited by availability, expense and resources [8, 9, 11, 19, 20, 35].…”