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Shi H, Lu P, Yu D, Wang J, Wang Z, Zhuang B, Shao C, Liu C, Liu B. The training of wrist arthroscopy. Front Med (Lausanne) 2022; 9:947459. [PMID: 36590938 PMCID: PMC9800421 DOI: 10.3389/fmed.2022.947459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
The wrist is a complex joint that bridges the hand to the forearm. Patients with wrist disorders increasingly prefer minimally invasive procedures for wrist joint diagnosis and treatment. Wrist arthroscopy offers direct visualization of the structures of the joint anatomy and existing disease processes while causing minimal damage to surrounding soft tissue. However, it requires a high level of technical ability for wrist arthroscopy practitioners. Therefore, an improved focus on wrist arthroscopy training combining new educational media and traditional practice should aid in the development of novel wrist arthroscopy training mode. This article aims to describe the status of wrist training and evaluation systems and introduce a new progressive wrist training system.
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Affiliation(s)
- Haifei Shi
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Pan Lu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China,Pan Lu
| | - Dongdong Yu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jiwen Wang
- China Academy of Space Technology, Beijing Institute of Control Engineering, Beijing, China
| | - Zhenhua Wang
- China Academy of Space Technology, Beijing Institute of Control Engineering, Beijing, China
| | - Baotang Zhuang
- China Academy of Space Technology, Beijing Institute of Control Engineering, Beijing, China
| | - Chao Shao
- China Academy of Space Technology, Beijing Institute of Control Engineering, Beijing, China
| | - Chang Liu
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Xicheng District, Beijing, China
| | - Bo Liu
- Department of Hand Surgery, Beijing Ji Shui Tan Hospital, Xicheng District, Beijing, China,*Correspondence: Bo Liu
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2
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Wang WL, Tosti R, Osterman AL. Surveying the Use and Perceptions of Wrist Arthroscopy Among Upper Extremity Surgeons. Orthopedics 2022; 45:310-313. [PMID: 35485882 DOI: 10.3928/01477447-20220425-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study describes current trends in the skill acquisition and practice patterns for wrist arthroscopy among upper extremity surgeons. A survey was sent to the membership of the American Association for Hand Surgery (AAHS). A total of 104 responses were available for analysis. Of those respondents who did not use wrist arthroscopy, lack of educational training was cited as the most common reason. Of those who did use arthroscopy, fellowship training was credited as the primary source. However, most of those who completed an instructional course felt immediately able to perform arthroscopy. Triangular fibrocartilage complex tears were recorded as the most common indication. Surgeons frequently evaluated the midcarpal joint, but did not frequently use arthroscopy for distal radio-ulnar joint or carpometacarpal joint pathology. Ultimately, this highlights an area of improvement for residency and fellowship education. [Orthopedics. 2022;45(5):310-313.].
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Hoyle AC, Talwalkar SC, Raj Murali S. Bare bones: Fundamentals of diagnostic wrist arthroscopy. J Clin Orthop Trauma 2021; 20:101478. [PMID: 34211833 PMCID: PMC8237361 DOI: 10.1016/j.jcot.2021.101478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/01/2021] [Accepted: 06/10/2021] [Indexed: 10/21/2022] Open
Abstract
Diagnostic wrist arthroscopy is an essential component of the modern orthopaedic wrist surgeon's skill set. Fundamental elements of diagnostic wrist arthroscopy include pre-operative planning and consent, operative set up, surface anatomy, a systematic approach and applied clinical anatomy, and closure. These fundamentals are described, including options and preferences for implementation. A sound understanding of these elements is key to lay the foundations for successful clinical procedures.
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Affiliation(s)
- Antonia C. Hoyle
- Wrightington Upper Limb Unit, Hall Lane Appley Bridge, Wigan, UK
| | | | - S. Raj Murali
- Wrightington Upper Limb Unit, Hall Lane Appley Bridge, Wigan, UK
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Eren MB, Bilgiç E. Novice Surgeon Portal Preference to Visualize the Femoral Anterior Cruciate Ligament Footprint: The Accessory Medial Portal Offers Improved Visualization. Arthrosc Sports Med Rehabil 2021; 3:e815-e822. [PMID: 34195649 PMCID: PMC8220608 DOI: 10.1016/j.asmr.2020.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/29/2020] [Indexed: 01/22/2023] Open
Abstract
Purpose To evaluate participant opinions on the appropriateness of different viewing angles by asking 8 questions, using visual content techniques. Methods Survey information from participants was used in this study. We used images of a patient who was operated on for symptomatic knee instability. Participants were asked whether the visual angle could determine the femoral tunnel entry point or evaluate anterior cruciate ligament (ACL) integrity. Results Questionnaires were completed by 40 participants. When all responses were evaluated, participant opinions on the accessory medial portal (AMP) were more positive than opinions on images taken from the anterolateral portal (ALP). These observations were statistically significant (P < .005). Both ACL integrity assessments and femoral tunnel entry site questions were evaluated, we observed that participant opinions on the AMP for both types of evaluation were more positive than opinions on the ALP. This observation was statistically significant (P < .005). When evaluations with photos and video transcripts were compared, no significant differences in terms of participant opinions were observed (P < .005). Conclusions AMP use may be a valuable tool for assistant and postgraduate education, as it offers a more suitable view angle for ACL reconstruction. Level of evidence Level V, survey study.
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Affiliation(s)
- Mehmet Burtaç Eren
- Department of Orthopaedics and Traumatology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Erkal Bilgiç
- Department of Orthopaedics and Traumatology, Gaziosmanpasa University School of Medicine, Tokat, Turkey
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Bielsa VF. Virtual reality simulation in plastic surgery training. Literature review. J Plast Reconstr Aesthet Surg 2021; 74:2372-2378. [PMID: 33972199 DOI: 10.1016/j.bjps.2021.03.066] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 11/07/2020] [Accepted: 03/13/2021] [Indexed: 11/19/2022]
Abstract
Major changes have occurred in the medical environment leading to an evolution from the traditional residency programmes to competency-based ones. Virtual reality (VR) represents a promising simulation resource for surgical training. Several types of VR simulators can be considered, depending on the level of immersion they offer. The goal of the article is to review the progress of VR simulation in plastic surgery (PS) training. A systematic search of the literature was performed on PUBMED/MEDLINE with the following key words: (Simulation OR Virtual Reality) AND (Education OR Training) AND Plastic Surgery from January 1998 to September 2019. A total of 244 results were found, and 80 of them were selected for abstract review. Sixty-four articles were selected for complete reading. Several attempts have been made to create VR simulators and most of them are non-immersive or partially immersive. The main conclusions of them are summarized. VR simulation has been proven to have a role in PS training, offering many advantages. Furthermore, VR simulation can be used for safety training, team interaction and decision-making education. Validation is a key point for acceptance of simulators. Further efforts are required to include simulation in PS curricula.
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Affiliation(s)
- V Fuertes Bielsa
- Plastic Surgery Department University Hospital Miguel Servet Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain.
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Li S, Li G, Liu Y, Xu W, Yang N, Chen H, Li N, Luo K, Jin S. Development and Assessment of a Gastroscopy Electronic Learning System for Primary Learners: Randomized Controlled Trial. J Med Internet Res 2020; 22:e16233. [PMID: 32202507 PMCID: PMC7136842 DOI: 10.2196/16233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/12/2020] [Accepted: 02/22/2020] [Indexed: 12/31/2022] Open
Abstract
Background Endoscopic examination is a popular and routine procedure for the diagnosis and treatment of gastrointestinal (GI) diseases. Skilled endoscopists are in great demand in clinical practice, but the training process for beginners to become endoscopy specialists is fairly long. Convenience and a self-paced, learner-centered approach make electronic learning (e-learning) an excellent instructional prospect. Objective This study aimed to develop and apply an e-learning system in gastroscopy teaching and learning and to evaluate its effectiveness and user satisfaction. Methods The e-learning software Gastroscope Roaming System was developed for primary learners. The system simulates the real structure of the upper gastrointestinal (UGI) tract to teach the main characteristics of gastroscopy under both normal conditions and conditions of common UGI tract diseases. A randomized controlled trial was conducted. Participants were randomly allocated to an e-learning group (EG)or a non–e-learning control group after a pretest. On completing the training, participants undertook a posttest and gastroscopy examination. In addition, the EG completed a satisfaction questionnaire. Results Of the 44 volunteers, 41 (93%) completed the gastroscopy learning and testing components. No significant pretest differences were found between the intervention and control groups (mean 50.86, SD 6.12 vs mean 50.76, SD 6.88; P=.96). After 1 month of learning, the EG’s posttest scores were higher (mean 83.70, SD 5.99 vs mean 78.76, SD 7.58; P=.03) and improved more (P=.01) than those of the control group, with better performance in the gastroscopy examination (mean 91.05, SD 4.58 vs mean 84.38, SD 5.19; P<.001). Overall, 85% (17/20) of the participants were satisfied with the e-learning system, and 95% (19/20) of the participants considered it successful. Conclusions E-learning is an effective educational strategy for primary learners to acquire skills in gastroscopy examination and endoscopic imaging of the GI tract. Trial Registration Chinese Clinical Trial Registry ChiCTR-IOR-17013091; http://www.chictr.org.cn/showproj.aspx?proj=22142
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Affiliation(s)
- Shuang Li
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Guoqing Li
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ying Liu
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wanying Xu
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ningning Yang
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Haoyuan Chen
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ning Li
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Kunpeng Luo
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shizhu Jin
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Ode G, Loeffler B, Chadderdon RC, Haines N, Scannell B, Patt J, Gaston G. Wrist Arthroscopy: Can We Gain Proficiency Through Knee Arthroscopy Simulation? JOURNAL OF SURGICAL EDUCATION 2018; 75:1664-1672. [PMID: 29730181 DOI: 10.1016/j.jsurg.2018.04.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 12/31/2017] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Wrist arthroscopy is a challenging discipline with limited training exposure during residency. The purpose of this study was to evaluate the effectiveness of virtual knee arthroscopy simulation training for gaining proficiency in wrist arthroscopy. DESIGN Participants were recorded performing a cadaveric wrist arthroscopy simulation. The residents then practiced knee arthroscopy on a virtual reality simulator and repeated the wrist arthroscopy simulation. All videos were blinded prior to assessment. Proficiency was graded using the Arthroscopic Surgery Skill Evaluation Tool global rating scale. In addition, participants were asked to complete a survey assessing the value of the virtual reality knee arthroscopy simulator for wrist arthroscopy. SETTING Orthopaedic Surgery Residency Program, Carolinas Medical Center, a large, public, nonprofit hospital located in Charlotte, North Carolina. PARTICIPANTS Orthopaedic residents at our center were asked to participate in the simulation training. Participation was voluntary and nonincentivized. All orthopaedic residents at our institution (N = 27) agreed to participate. In total, there were 10 Intern (PGY-0 and PGY-1), 10 Junior (PGY-2 and PGY-3), and 7 Senior (PGY-4 and PGY-5) residents. In addition, a fellowship-trained hand surgeon was recruited to participate in the study, performing the wrist arthoscopy simulation. Two additional fellowship-trained hand surgeons, for a total of 3, assessed the blinded videos. RESULTS There was a trend toward better wrist Arthroscopic Surgery Skill Evaluation Tool scores by training level, although the difference was not statistically significant. Interns improved by an average of 1.8 points between baseline and postknee simulation tests. Junior and senior residents decreased by 1.6 and 5.0 points, respectively. CONCLUSIONS Knee arthroscopy simulation training did not objectively improve wrist arthroscopy proficiency among residents. A wrist-specific arthroscopy simulation program is needed if measurable competence through simulation is desired.
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Affiliation(s)
- Gabriella Ode
- Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | | | | | - Nikkole Haines
- Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Brian Scannell
- Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Joshua Patt
- Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - Glenn Gaston
- OrthoCarolina Hand Center, Charlotte, North Carolina.
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Obdeijn MC, Horeman T, de Boer LL, van Baalen SJ, Liverneaux P, Tuijthof GJM. Navigation forces during wrist arthroscopy: assessment of expert levels. Knee Surg Sports Traumatol Arthrosc 2016; 24:3684-3692. [PMID: 25448136 DOI: 10.1007/s00167-014-3450-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 11/17/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE To facilitate effective and efficient training in skills laboratory, objective metrics can be used. Forces exerted on the tissues can be a measure of safe tissue manipulation. To provide feedback during training, expert threshold levels need to be determined. The purpose of this study was to define the magnitude and the direction of navigation forces used during arthroscopic inspection of the wrist. METHODS We developed a set-up to mount a cadaver wrist to a 3D force platform that allowed measurement of the forces exerted on the wrist. Six experts in wrist arthroscopy performed two tasks: (1) Introduction of the camera and visualization of the hook. (2) Navigation through the wrist with visualization of five anatomic structures. The magnitude (Fabs) and direction of force were recorded, with the direction defined as α being the angle in the vertical plane and β being the angle in the horizontal plane. The 10th-90th percentile of the data were used to set threshold levels for training. RESULTS The results show distinct force patterns for each of the anatomic landmarks. Median Fabs of the navigation task is 3.8 N (1.8-7.3), α is 3.60 (-54-44) and β is 260 (0-72). CONCLUSION Unique expert data on navigation forces during wrist arthroscopy were determined. The defined maximum allowable navigation force of 7.3 N (90th percentile) can be used in providing feedback on performance during skills training. The clinical value is that this study contributes to objective assessment of skills levels.
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Affiliation(s)
- Miryam C Obdeijn
- Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - Tim Horeman
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Lisanne L de Boer
- Department of Technical Medicine, MIRA Institute for Biomedical Technology and Technical Medicine Enschede, University of Twente, Enschede, Netherlands
| | - Sophie J van Baalen
- Department of Technical Medicine, MIRA Institute for Biomedical Technology and Technical Medicine Enschede, University of Twente, Enschede, Netherlands
| | - Philippe Liverneaux
- Department of Hand Surgery, Strasbourg University Hospitals, Illkirch, France
| | - Gabrielle J M Tuijthof
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands.,Department of Orthopedic Surgery, Orthopedic Research Center Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
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Validation of a simulator for temporomandibular joint arthroscopy. Int J Oral Maxillofac Surg 2016; 45:836-41. [DOI: 10.1016/j.ijom.2016.01.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 10/23/2015] [Accepted: 01/19/2016] [Indexed: 11/19/2022]
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10
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Hinds RM, Gottschalk MB, Strauss EJ, Capo JT. Trends in Arthroscopic Procedures Performed During Orthopaedic Residency: An Analysis of Accreditation Council for Graduate Medical Education Case Log Data. Arthroscopy 2016; 32:645-50. [PMID: 26821961 DOI: 10.1016/j.arthro.2015.11.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 11/03/2015] [Accepted: 11/03/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To analyze orthopaedic resident case log data to report temporal trends in performing arthroscopic procedures and to assess variability in arthroscopic case volume among residents. METHODS Accreditation Council for Graduate Medical Education orthopaedic surgery resident case logs were reviewed from 2007 to 2013. The mean number of wrist, elbow, shoulder, knee, and ankle arthroscopic procedures performed by graduating residents was analyzed. The median number of arthroscopic procedures reported by the 70th and 30th percentiles of graduating residents (by arthroscopic case volume) was also recorded. Temporal trends were assessed using a linear regression model. RESULTS From 2007 to 2013, there were significant increases in the mean number of wrist (5.8 to 6.3; P = .038), elbow (2.5 to 3.2; P < .001), shoulder (93.5 to 133.8; P < .001), knee (170.6 to 185.1; P = .011), and ankle (5.8 to 7.4; P < .001) arthroscopies performed per resident. Residents in the 70th percentile of caseload performed significantly more wrist (7 v 2; P < .001), elbow (3.3 v 1; P < .001), shoulder (134.1 v 70.6; P < .001), knee (205 v 128.7; P < .001), and ankle (7.9 v 2.9; P < .001) arthroscopies than residents in the 30th percentile. CONCLUSIONS Our findings indicate that arthroscopic caseload is increasing among orthopaedic residents. However, resident experience performing arthroscopic procedures is substantially disparate. Although the educational implications of this disparity are not well understood, our findings may aid in efforts to optimize arthroscopic training during orthopaedic residency.
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Affiliation(s)
- Richard M Hinds
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, U.S.A..
| | - Michael B Gottschalk
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, U.S.A
| | - Eric J Strauss
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, U.S.A
| | - John T Capo
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, U.S.A
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Gandhi MJ, Anderton MJ, Funk L. Arthroscopic Skills Acquisition Tools: An Online Simulator for Arthroscopy Training. Arthroscopy 2015; 31:1671-9. [PMID: 26070927 DOI: 10.1016/j.arthro.2015.03.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 02/20/2015] [Accepted: 03/13/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To evaluate correlations between objective performances measured by a new online arthroscopic skills acquisition tool (ASAT, in which "shape match" with inverted controls requires lifting shapes and releasing them into their corresponding silhouettes) and a validated virtual reality (VR) shoulder arthroscopy simulator (Insight Arthro VR; GMV, Madrid, Spain). METHODS Forty-nine medical students familiarized themselves with 5 ASATs. They were then assessed using a sixth ASAT (shape match with inverted controls) and 4 VR tasks (operating room, visualize, locate and palpate, and pendulum) on the VR simulator. Correlations were assessed between 11 ASAT measures and 15 VR measures using Pearson correlation coefficients. RESULTS Time taken and delta distance (actual distance minus minimum distance traveled) were the most frequent and correlated ASAT measures. Time taken correlated with the VR locate-and-palpate time (r = 0.596, P < .001), visualize time (r = 0.381, P = .007), and pendulum time (r = 0.646, P < .001), whereas delta distance correlated with the locate-and-palpate camera distance (r = 0.667, P < .001), instrument distance (r = 0.664, P < .001), visualize distance (r = 0.4, P = .004), pendulum camera distance (r = 0.538, P < .001), and instrument distance (r = 0.539, P < .001). CONCLUSIONS There were significant correlations between performance measures on the ASAT and a validated arthroscopic VR simulator. CLINICAL RELEVANCE Arthroscopic simulators are available but are limited by their high cost and availability. ASATs may overcome these limitations by using widely available Internet-based software and basic input devices.
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Affiliation(s)
- Maulik J Gandhi
- Orthopaedic Institute, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, England.
| | | | - Lennard Funk
- Upper Limb Unit, Wrightington Hospital, Wigan, England
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12
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Frank RM, Erickson B, Frank JM, Bush-Joseph CA, Bach BR, Cole BJ, Romeo AA, Provencher MT, Verma NN. Utility of modern arthroscopic simulator training models. Arthroscopy 2014; 30:121-33. [PMID: 24290789 DOI: 10.1016/j.arthro.2013.09.084] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 09/19/2013] [Accepted: 09/26/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to review the published literature on modern arthroscopic simulator training models to (1) determine the ability to transfer skills learned on the model to the operating room and (2) determine the learning curve required to translate such skills. METHODS A systematic review of all studies using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed. Two independent reviewers then analyzed studies deemed appropriate for inclusion. Study data collected included participant demographic characteristics, simulator model, type and number of tasks, method of analysis, and results of training, when available. Given the different methods used in each study, descriptive analysis was performed. RESULTS Nineteen studies met the inclusion criteria (9 shoulder, 9 knee, and 1 hip). A total of 465 participants with a mean age of 30 years were evaluated. Twelve studies (63%) compared task performance among participants of different experience levels, with 100% reporting a positive correlation between experience level and simulator performance. Eight studies (42%) evaluated task performance before and after simulator training, with 6 studies showing improvement after training; 1 study noted no difference in performance after 1 hour of training. One study commented on improved operating room performance after simulator training. No studies commented on the number of training sessions needed to translate skills learned on the models to the operating room. CONCLUSIONS This review suggests that practice on arthroscopic simulators improves performance on arthroscopic simulators. We cannot, however, definitively comment on whether simulator training correlates to an improved skill set in the operating room. Further work is needed to determine the type and number of training sessions needed to translate arthroscopic skills learned on the models to the operating room. LEVEL OF EVIDENCE Level IV, systematic review of studies with Level I through IV evidence.
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Affiliation(s)
- Rachel M Frank
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A..
| | - Brandon Erickson
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A
| | - Jonathan M Frank
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A
| | - Charles A Bush-Joseph
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A
| | - Bernard R Bach
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A
| | - Brian J Cole
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A
| | - Anthony A Romeo
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A
| | - Matthew T Provencher
- Sports Medicine Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Nikhil N Verma
- Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A
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