Cargando…

Arthroscopy Skills Development with a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents

OBJECTIVES: Traditional resident assessment of orthopaedic surgical technical proficiency relies exclusively on subjective parameters. More standardized objective measures are needed to ensure training consistency and surgical competency. The purpose of this study was to determine if orthopaedic sur...

Descripción completa

Detalles Bibliográficos
Autores principales: Rebolledo, Brian J., Leali, Alejandro, Hammann, Jennifer, Ranawat, Anil S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597536/
http://dx.doi.org/10.1177/2325967114S00070
_version_ 1782393943816667136
author Rebolledo, Brian J.
Leali, Alejandro
Hammann, Jennifer
Ranawat, Anil S.
author_facet Rebolledo, Brian J.
Leali, Alejandro
Hammann, Jennifer
Ranawat, Anil S.
author_sort Rebolledo, Brian J.
collection PubMed
description OBJECTIVES: Traditional resident assessment of orthopaedic surgical technical proficiency relies exclusively on subjective parameters. More standardized objective measures are needed to ensure training consistency and surgical competency. The purpose of this study was to determine if orthopaedic surgery residents who train with a virtual reality simulator can lead to improved arthroscopy performance and to determine if a standardized arthroscopic shoulder and knee test were appropriate means for evaluating a resident's arthroscopic skill after completing a training course. METHODS: Study participants were first and second year orthopaedic surgery residents at a single institution who were randomized to either train on the virtual reality surgical simulator (Insight Arthro VR) for a total of 2.5 hours (n=8) or receive 2 hours of didactic lectures with models (non-simulator) (n=6). Both groups were then evaluated in both knee and shoulder arthroscopy using a cadaver. Performance was measured by time to completion of a standardized protocol checklist and cartilage grading index (CGI) (scale 0-10). RESULTS: All subjects had no previous arthroscopy experience prior to the study. The simulator group had a shorter time to completion in both knee (simulator: 5.1 ± 1.8 min, non-simulator: 8.0 ± 4.4 min; p=0.09) and shoulder (simulator: 6.1 ± 1.5 min, non-simulator: 9.9 ± 3.2 min; p=0.02) arthroscopy. Similarly, the simulator group had improved CGI scores in both the knee (simulator: 4.0 ± 1.1, non-simulator: 5.3 ± 1.5; p=0.07) and shoulder (simulator: 3.4 ± 0.8, non-simulator: 5.5 ± 1.6; p=0.008) arthroscopy. CONCLUSION: This study suggests that surgical simulators are beneficial in arthroscopy skills development for orthopaedic surgery residents. An arthroscopic testing model was able to measure a statistical improvement for a resident's arthroscopic skill. Instituting standardized cadaveric testing based on common orthopaedic surgical procedures such as knee and shoulder arthroscopy will not only ensure graduating residents possess the necessary skills to be technically proficient surgeons but it will also allow objective identification of residents in need of remediation.
format Online
Article
Text
id pubmed-4597536
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-45975362015-11-03 Arthroscopy Skills Development with a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents Rebolledo, Brian J. Leali, Alejandro Hammann, Jennifer Ranawat, Anil S. Orthop J Sports Med Article OBJECTIVES: Traditional resident assessment of orthopaedic surgical technical proficiency relies exclusively on subjective parameters. More standardized objective measures are needed to ensure training consistency and surgical competency. The purpose of this study was to determine if orthopaedic surgery residents who train with a virtual reality simulator can lead to improved arthroscopy performance and to determine if a standardized arthroscopic shoulder and knee test were appropriate means for evaluating a resident's arthroscopic skill after completing a training course. METHODS: Study participants were first and second year orthopaedic surgery residents at a single institution who were randomized to either train on the virtual reality surgical simulator (Insight Arthro VR) for a total of 2.5 hours (n=8) or receive 2 hours of didactic lectures with models (non-simulator) (n=6). Both groups were then evaluated in both knee and shoulder arthroscopy using a cadaver. Performance was measured by time to completion of a standardized protocol checklist and cartilage grading index (CGI) (scale 0-10). RESULTS: All subjects had no previous arthroscopy experience prior to the study. The simulator group had a shorter time to completion in both knee (simulator: 5.1 ± 1.8 min, non-simulator: 8.0 ± 4.4 min; p=0.09) and shoulder (simulator: 6.1 ± 1.5 min, non-simulator: 9.9 ± 3.2 min; p=0.02) arthroscopy. Similarly, the simulator group had improved CGI scores in both the knee (simulator: 4.0 ± 1.1, non-simulator: 5.3 ± 1.5; p=0.07) and shoulder (simulator: 3.4 ± 0.8, non-simulator: 5.5 ± 1.6; p=0.008) arthroscopy. CONCLUSION: This study suggests that surgical simulators are beneficial in arthroscopy skills development for orthopaedic surgery residents. An arthroscopic testing model was able to measure a statistical improvement for a resident's arthroscopic skill. Instituting standardized cadaveric testing based on common orthopaedic surgical procedures such as knee and shoulder arthroscopy will not only ensure graduating residents possess the necessary skills to be technically proficient surgeons but it will also allow objective identification of residents in need of remediation. SAGE Publications 2014-08-01 /pmc/articles/PMC4597536/ http://dx.doi.org/10.1177/2325967114S00070 Text en © The Author(s) 2014 http://creativecommons.org/licenses/by-nc-nd/3.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav.
spellingShingle Article
Rebolledo, Brian J.
Leali, Alejandro
Hammann, Jennifer
Ranawat, Anil S.
Arthroscopy Skills Development with a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents
title Arthroscopy Skills Development with a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents
title_full Arthroscopy Skills Development with a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents
title_fullStr Arthroscopy Skills Development with a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents
title_full_unstemmed Arthroscopy Skills Development with a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents
title_short Arthroscopy Skills Development with a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents
title_sort arthroscopy skills development with a surgical simulator: a comparative study in orthopaedic surgery residents
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597536/
http://dx.doi.org/10.1177/2325967114S00070
work_keys_str_mv AT rebolledobrianj arthroscopyskillsdevelopmentwithasurgicalsimulatoracomparativestudyinorthopaedicsurgeryresidents
AT lealialejandro arthroscopyskillsdevelopmentwithasurgicalsimulatoracomparativestudyinorthopaedicsurgeryresidents
AT hammannjennifer arthroscopyskillsdevelopmentwithasurgicalsimulatoracomparativestudyinorthopaedicsurgeryresidents
AT ranawatanils arthroscopyskillsdevelopmentwithasurgicalsimulatoracomparativestudyinorthopaedicsurgeryresidents