Abstract
Background: There is a paucity of articles in the surgical literature demonstrating transfer validity (transfer of training). The purpose of this study was to assess whether skills learned on the ArthroSim virtual-reality arthroscopic knee simulator transferred to greater skill levels in the operating room.
Methods: Postgraduate year-3 orthopaedic residents were randomized into simulator-trained and control groups at seven academic institutions. The experimental group trained on the simulator, performing a knee diagnostic arthroscopy procedure to a predetermined proficiency level based on the average proficiency of five community-based orthopaedic surgeons performing the same procedure on the simulator. The residents in the control group continued their institution-specific orthopaedic education and training. Both groups then performed a diagnostic knee arthroscopy procedure on a live patient. Video recordings of the arthroscopic surgery were analyzed by five pairs of expert arthroscopic surgeons blinded to the identity of the residents. A proprietary global rating scale and a procedural checklist, which included visualization and probing scales, were used for rating.
Conclusions: We have demonstrated transfer validity (transfer of training) that residents trained to proficiency on a high-fidelity realistic virtual-reality arthroscopic knee simulator showed a greater skill level in the operating room compared with the control group.
Clinical Relevance: We believe that the results of our study will stimulate residency program directors to incorporate surgical simulation into the core curriculum of their residency programs.
Results: Forty-eight (89%) of the fifty-four postgraduate year-3 residents from seven academic institutions completed the study. The simulator-trained group averaged eleven hours of training on the simulator to reach proficiency. The simulator-trained group performed significantly better when rated according to our procedural checklist (p = 0.031), including probing skills (p = 0.016) but not visualization skills (p = 0.34), compared with the control group. The procedural checklist weighted probing skills double the weight of visualization skills. The global rating scale failed to reach significance (p = 0.061) because of one extreme outlier. The duration of the procedure was not significant. This lack of a significant difference seemed to be related to the fact that residents in the control group were less thorough, which shortened their time to completion of the arthroscopic procedure.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1798-1806 |
| Number of pages | 9 |
| Journal | Journal of Bone and Joint Surgery - American Volume |
| Volume | 96 |
| Issue number | 21 |
| DOIs | |
| State | Published - Nov 5 2014 |
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ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
Cite this
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Improving residency training in arthroscopic knee surgery with use of a virtual-reality simulator : A randomized blinded study. / Cannon, W. Dilworth; Garrett, William E.; Hunter, Robert E.; Sweeney, Howard J.; Eckhoff, Donald G.; Nicandri, Gregg T.; Hutchinson, Mark R.; Johnson, Donald D.; Bisson, Leslie J.; Bedi, Asheesh; Hill, James A; Koh, Jason L.; Reinig, Karl D.
In: Journal of Bone and Joint Surgery - American Volume, Vol. 96, No. 21, 05.11.2014, p. 1798-1806.Research output: Contribution to journal › Article
TY - JOUR
T1 - Improving residency training in arthroscopic knee surgery with use of a virtual-reality simulator
T2 - A randomized blinded study
AU - Cannon, W. Dilworth
AU - Garrett, William E.
AU - Hunter, Robert E.
AU - Sweeney, Howard J.
AU - Eckhoff, Donald G.
AU - Nicandri, Gregg T.
AU - Hutchinson, Mark R.
AU - Johnson, Donald D.
AU - Bisson, Leslie J.
AU - Bedi, Asheesh
AU - Hill, James A
AU - Koh, Jason L.
AU - Reinig, Karl D.
PY - 2014/11/5
Y1 - 2014/11/5
N2 - Background: There is a paucity of articles in the surgical literature demonstrating transfer validity (transfer of training). The purpose of this study was to assess whether skills learned on the ArthroSim virtual-reality arthroscopic knee simulator transferred to greater skill levels in the operating room.Methods: Postgraduate year-3 orthopaedic residents were randomized into simulator-trained and control groups at seven academic institutions. The experimental group trained on the simulator, performing a knee diagnostic arthroscopy procedure to a predetermined proficiency level based on the average proficiency of five community-based orthopaedic surgeons performing the same procedure on the simulator. The residents in the control group continued their institution-specific orthopaedic education and training. Both groups then performed a diagnostic knee arthroscopy procedure on a live patient. Video recordings of the arthroscopic surgery were analyzed by five pairs of expert arthroscopic surgeons blinded to the identity of the residents. A proprietary global rating scale and a procedural checklist, which included visualization and probing scales, were used for rating.Conclusions: We have demonstrated transfer validity (transfer of training) that residents trained to proficiency on a high-fidelity realistic virtual-reality arthroscopic knee simulator showed a greater skill level in the operating room compared with the control group.Clinical Relevance: We believe that the results of our study will stimulate residency program directors to incorporate surgical simulation into the core curriculum of their residency programs.Results: Forty-eight (89%) of the fifty-four postgraduate year-3 residents from seven academic institutions completed the study. The simulator-trained group averaged eleven hours of training on the simulator to reach proficiency. The simulator-trained group performed significantly better when rated according to our procedural checklist (p = 0.031), including probing skills (p = 0.016) but not visualization skills (p = 0.34), compared with the control group. The procedural checklist weighted probing skills double the weight of visualization skills. The global rating scale failed to reach significance (p = 0.061) because of one extreme outlier. The duration of the procedure was not significant. This lack of a significant difference seemed to be related to the fact that residents in the control group were less thorough, which shortened their time to completion of the arthroscopic procedure.
AB - Background: There is a paucity of articles in the surgical literature demonstrating transfer validity (transfer of training). The purpose of this study was to assess whether skills learned on the ArthroSim virtual-reality arthroscopic knee simulator transferred to greater skill levels in the operating room.Methods: Postgraduate year-3 orthopaedic residents were randomized into simulator-trained and control groups at seven academic institutions. The experimental group trained on the simulator, performing a knee diagnostic arthroscopy procedure to a predetermined proficiency level based on the average proficiency of five community-based orthopaedic surgeons performing the same procedure on the simulator. The residents in the control group continued their institution-specific orthopaedic education and training. Both groups then performed a diagnostic knee arthroscopy procedure on a live patient. Video recordings of the arthroscopic surgery were analyzed by five pairs of expert arthroscopic surgeons blinded to the identity of the residents. A proprietary global rating scale and a procedural checklist, which included visualization and probing scales, were used for rating.Conclusions: We have demonstrated transfer validity (transfer of training) that residents trained to proficiency on a high-fidelity realistic virtual-reality arthroscopic knee simulator showed a greater skill level in the operating room compared with the control group.Clinical Relevance: We believe that the results of our study will stimulate residency program directors to incorporate surgical simulation into the core curriculum of their residency programs.Results: Forty-eight (89%) of the fifty-four postgraduate year-3 residents from seven academic institutions completed the study. The simulator-trained group averaged eleven hours of training on the simulator to reach proficiency. The simulator-trained group performed significantly better when rated according to our procedural checklist (p = 0.031), including probing skills (p = 0.016) but not visualization skills (p = 0.34), compared with the control group. The procedural checklist weighted probing skills double the weight of visualization skills. The global rating scale failed to reach significance (p = 0.061) because of one extreme outlier. The duration of the procedure was not significant. This lack of a significant difference seemed to be related to the fact that residents in the control group were less thorough, which shortened their time to completion of the arthroscopic procedure.
UR - http://www.scopus.com/inward/record.url?scp=84910652036&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84910652036&partnerID=8YFLogxK
U2 - 10.2106/JBJS.N.00058
DO - 10.2106/JBJS.N.00058
M3 - Article
C2 - 25378507
AN - SCOPUS:84910652036
VL - 96
SP - 1798
EP - 1806
JO - The Journal of bone and joint surgery. American volume
JF - The Journal of bone and joint surgery. American volume
SN - 0021-9355
IS - 21
ER -