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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-10-2019 | Hip

Virtual reality hip arthroscopy simulator demonstrates sufficient face validity

Authors: Jonathan D. Bartlett, John E. Lawrence, Vikas Khanduja

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2019

Abstract

Purpose

To test the face validity of the hip diagnostics module of a virtual reality hip arthroscopy simulator.

Methods

A total of 25 orthopaedic surgeons, 7 faculty members and 18 orthopaedic residents, performed diagnostic supine hip arthroscopies of a healthy virtual reality hip joint using a 70° arthroscope. Twelve specific targets were visualised within the central compartment; six via the anterior portal, three via the anterolateral portal and three via the posterolateral portal. This task was immediately followed by a questionnaire regarding the realism and training capability of the system. This consisted of seven questions addressing the verisimilitude of the simulator and five questions addressing the training environment of the simulator. Each question consisted of a statement stem and 10-point Likert scale. Following similar work in surgical simulators, a rating of 7 or above was considered an acceptable level of realism.

Results

The diagnostic hip arthroscopy module was found to have an acceptable level of realism in all domains apart from the tactile feedback received from the soft tissue. 23 out of 25 participants (92%) felt the simulator provided a non-threatening learning environment and 22 participants (88%) stated they enjoyed using the simulator. It was most frequently agreed that the level of trainees who would benefit most from the simulator were registrars and fellows (22 participants; 88%). Additionally, 21 of the participants (84%) agreed that this would be a beneficial training modality for foundation and core trainees, and 20 participants (80%) agreed that his would be beneficial for consultants.

Conclusions

This VR hip arthroscopy simulator was demonstrated to have a sufficient level of realism, thus establishing its face validity. These results suggest this simulator has sufficient realism for use in the acquisition of basic arthroscopic skills and supports its use in orthopaedics surgical training.

Level of evidence

Available only for authorised users

Akhtar KSN, Chen A, Standfield NJ, Gupte CM (2014) The role of simulation in developing surgical skills. Curr Rev Musculoskelet Med 7:155–160CrossRefPubMedPubMedCentral

Barnes RW (1987) Surgical handicraft: teaching and learning surgical skills. Am J Surg 153:422–427CrossRefPubMed

Braman JP, Sweet RM, Hananel DM, Ludewig PM, Van Heest AE (2015) Development and validation of a basic arthroscopy skills simulator. Arthroscopy 31:104–112CrossRefPubMed

Camp CL, Krych AJ, Stuart MJ, Regnier TD, Mills KM, Turner NS (2016) Improving resident performance in knee arthroscopy: a prospective value assessment of simulators and cadaveric skills laboratories. J Bone Jt Surg Am 98:220–225CrossRef

Cannon WD, Garrett WE, Hunter RE, Sweeney HJ, Eckhoff DG, Nicandri GT, Hutchinson MR, Johnson DD, Bisson LJ, Bedi A, Hill JA, Koh JL, Reinig KD (2014) Improving residency training in arthroscopic knee surgery with use of a virtual-reality simulator. A randomized blinded study. J Bone Jt Surg Am 96:1798–1806CrossRef

Connors RC, Doty JR, Bull DA, May HT, Fullerton DA, Robbins RC (2009) Effect of work-hour restriction on operative experience in cardiothoracic surgical residency training. J Thorac Cardiovasc Surg 137:710–713CrossRefPubMed

Elbadrawy M, Majoko F, Gasson J (2008) Impact of Calman system and recent reforms on surgical training in gynaecology. J Obstet Gynaecol J Inst Obstet Gynaecol 28:474–477CrossRef

Escoto A, Le Ber F, Trejos AL, Naish MD, Patel RV, Lebel M-E (2013) A knee arthroscopy simulator: design and validation. Conf Proc Annu Int Conf IEEE Eng Med Biol Soc IEEE Eng Med Biol Soc Annu Conf 2013:5715–5718

Farnworth LR, Lemay DE, Wooldridge T, Mabrey JD, Blaschak M, DeCoster TA, Wascher DC, Schenck RC (2001) A comparison of operative times in arthroscopic ACL reconstruction between orthopaedic faculty and residents: the financial impact of orthopaedic surgical training in the operating room. Iowa Orthop J 21:31–35PubMedPubMedCentral

10.

Fucentese SF, Rahm S, Wieser K, Spillmann J, Harders M, Koch PP (2015) Evaluation of a virtual-reality-based simulator using passive haptic feedback for knee arthroscopy. Knee Surg Sports Traumatol Arthrosc 23:1077–1085CrossRefPubMed

11.

Gallagher AG, Ritter EM, Champion H, Higgins G, Fried MP, Moses G, Smith CD, Satava RM (2005) Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 241:364–372CrossRefPubMedPubMedCentral

12.

Gallagher AG, Seymour NE, Jordan-Black J-A, Bunting BP, McGlade K, Satava RM (2013) Prospective, randomized assessment of transfer of training (ToT) and transfer effectiveness ratio (TER) of virtual reality simulation training for laparoscopic skill acquisition. Ann Surg 257:1025–1031CrossRefPubMed

13.

Garfjeld Roberts P, Guyver P, Baldwin M, Akhtar K, Alvand A, Price AJ, Rees JL (2017) Validation of the updated ArthroS simulator: face and construct validity of a passive haptic virtual reality simulator with novel performance metrics. Knee Surg Sports Traumatol Arthrosc 25:616–625CrossRefPubMed

14.

Hoppe DJ, de Sa D, Simunovic N, Bhandari M, Safran MR, Larson CM, Ayeni OR (2014) The learning curve for hip arthroscopy: a systematic review. Arthroscopy 30:389–397CrossRefPubMed

15.

Hunter JG, Sackier JM, Berci G (1994) Training in laparoscopic cholecystectomy. Quantifying the learning curve. Surg Endosc 8:28–31CrossRefPubMed

16.

Jacobsen ME, Andersen MJ, Hansen CO, Konge L (2015) Testing basic competency in knee arthroscopy using a virtual reality simulator: exploring validity and reliability. J Bone Jt Surg Am 97:775–781CrossRef

17.

Khanduja V, Lawrence JE, Audenaert E (2017) Testing the construct validity of a virtual reality hip arthroscopy simulator. Arthroscopy 33:566–571CrossRefPubMed

18.

Konan S, Rhee S-J, Haddad FS (2011) Hip arthroscopy: analysis of a single surgeon’s learning experience. J Bone Jt Surg Am 93(Suppl 2):52–56CrossRef

19.

Kunkler K (2006) The role of medical simulation: an overview. Int J Med Robot 2:203–210CrossRefPubMed

20.

Lee Y-K, Ha Y-C, Hwang D-S, Koo K-H (2013) Learning curve of basic hip arthroscopy technique: CUSUM analysis. Knee Surg Sports Traumatol Arthrosc 21:1940–1944CrossRefPubMed

21.

Luft HS, Bunker JP, Enthoven AC (2007) Should operations be regionalized? The empirical relation between surgical volume and mortality. 1979. Clin Orthop Relat Res 457:3–9CrossRefPubMed

22.

Martin KD, Cameron K, Belmont PJ, Schoenfeld A, Owens BD (2012) Shoulder arthroscopy simulator performance correlates with resident and shoulder arthroscopy experience. J Bone Jt Surg Am 94:e160CrossRef

23.

Palter VN, Grantcharov T, Harvey A, Macrae HM (2011) Ex vivo technical skills training transfers to the operating room and enhances cognitive learning: a randomized controlled trial. Ann Surg 253:886–889CrossRefPubMed

24.

Pedowitz RA, Esch J, Snyder S (2002) Evaluation of a virtual reality simulator for arthroscopy skills development. Arthroscopy 18:E29CrossRefPubMed

25.

Rahm S, Germann M, Hingsammer A, Wieser K, Gerber C (2016) Validation of a virtual reality-based simulator for shoulder arthroscopy. Knee Surg Sports Traumatol Arthrosc 24:1730–1737CrossRefPubMed

26.

Rebolledo BJ, Hammann-Scala J, Leali A, Ranawat AS (2015) Arthroscopy skills development with a surgical simulator: a comparative study in orthopaedic surgery residents. Am J Sports Med 43:1526–1529CrossRefPubMed

27.

Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236:458–463; discussion 463–464CrossRefPubMedPubMedCentral

28.

Stefanidis D, Scerbo MW, Montero PN, Acker CE, Smith WD (2012) Simulator training to automaticity leads to improved skill transfer compared with traditional proficiency-based training: a randomized controlled trial. Ann Surg 255:30–37CrossRefPubMed

29.

Stunt J, Wulms P, Kerkhoffs G, Dankelman J, van Dijk C, Tuijthof G (2014) How valid are commercially available medical simulators? Adv Med Educ Pract 5:385–395CrossRefPubMedPubMedCentral

30.

Stunt JJ, Kerkhoffs GMMJ, van Dijk CN, Tuijthof GJM (2015) Validation of the ArthroS virtual reality simulator for arthroscopic skills. Knee Surg Sports Traumatol Arthrosc 23:3436–3442CrossRefPubMed

31.

Stunt JJ, Kerkhoffs GMMJ, Horeman T, van Dijk CN, Tuijthof GJM (2016) Validation of the PASSPORT V2 training environment for arthroscopic skills. Knee Surg Sports Traumatol Arthrosc 24:2038–2045CrossRefPubMed

32.

Tuijthof GJM, Visser P, Sierevelt IN, Van Dijk CN, Kerkhoffs GMMJ (2011) Does perception of usefulness of arthroscopic simulators differ with levels of experience? Clin Orthop Relat Res 469:1701–1708CrossRefPubMedPubMedCentral

33.

Waterman BR, Martin KD, Cameron KL, Owens BD, Belmont PJ (2016) Simulation training improves surgical proficiency and safety during diagnostic shoulder arthroscopy performed by residents. Orthopedics 39:e479–e485CrossRefPubMed

Title: Virtual reality hip arthroscopy simulator demonstrates sufficient face validity
Authors: Jonathan D. Bartlett
John E. Lawrence
Vikas Khanduja
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2019
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-018-5038-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Virtual reality hip arthroscopy simulator demonstrates sufficient face validity

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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