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International Orthopaedics

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01-05-2020 | Arthroscopy | Original Paper

Evaluation of arthroscopic skills with a virtual reality simulator in first-year orthopaedic residents

Authors: P. Walbron, H. Common, H. Thomazeau, F. Sirveaux

Published in: International Orthopaedics | Issue 5/2020

Abstract

Purpose

This study of residents’ initial performance was performed to determine which factors predisposed residents for success in demonstrating the best arthroscopic skills.

Methods

Each orthopaedic first-year resident was officially invited to take part in a one hour evaluation on a VirtaMed™ ArthroS™ simulator. On the FAST module, the Periscoping exercise was chosen to test for use of angled optics. The Shoulder Module was chosen to test their ability to extract intra-articular foreign bodies using the Catch the Stars exercise. The variables such as time, camera alignment, camera path length, and grasper path length were analysed. Residents completed a questionnaire prior to the evaluation. Their results were analysed according to gender, orientation assessment, and surgical history.

Results

A total of 34 women and 82 men were included in the study. In the Periscoping exercise, a significant difference between women and men in the time variables was noticed (275 ± 82 and 195 ± 71; p < 0.00001) and camera path length (207 ± 60 and 170 ± 66; p = 0.00094). For the Catch the Stars exercise, there was a significant difference between women and men for the time values (249 ± 114 and 201 ± 99; p = 0.01246) and grasper path length (290 ± 130 and 229 ± 108; p = 0.00493). After multivariate analysis, no influence of self-assessed spatial perception (p=0.1), number of arthroscopic procedures (p=0.39), or laparoscopic procedures (p=0.43) to which they had already assisted was found.

Conclusions

This study shows a significant difference in skills regarding spatial recognition and triangulation related to gender at the beginning of specialization training. It also demonstrates that male medical students are more attracted by surgical departments during their medical training.

Bonnafous S, Amiot-Chanal H, Rouanet P (2017) Arrêté du 12 avril 2017 portant organisation du troisième cycle des études de médecine

Rohrich RJ (2006) “See one, do one, teach one”: an old adage with a new twist. Plast Reconstr Surg 118:257–258. https://doi.org/10.1097/01.prs.0000233177.97881.85 CrossRefPubMed

Bjerrum F, Thomsen ASS, Nayahangan LJ, Konge L (2018) Surgical simulation: current practices and future perspectives for technical skills training. Med Teach:1–8. https://doi.org/10.1080/0142159X.2018.1472754

Dunn JC, Belmont PJ, Lanzi J et al (2015) Arthroscopic shoulder surgical simulation training curriculum: transfer reliability and maintenance of skill over time. J Surg Educ 72:1118–1123. https://doi.org/10.1016/j.jsurg.2015.06.021 CrossRefPubMed

Waterman BR, Martin KD, Cameron KL et al (2016) Simulation training improves surgical proficiency and safety during diagnostic shoulder arthroscopy performed by residents. Orthopedics 39:e479–e485. https://doi.org/10.3928/01477447-20160427-02 CrossRefPubMed

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 43:1526–1529. https://doi.org/10.1177/0363546515574064 CrossRefPubMed

Jackson WFM, Khan T, Alvand A et al (2012) Learning and retaining simulated arthroscopic meniscal repair skills. J Bone Joint Surg Am 94:e132. https://doi.org/10.2106/JBJS.K.01438 CrossRefPubMed

Martin KD, Patterson DP, Cameron KL (2016) Arthroscopic training courses improve trainee arthroscopy skills: a simulation-based prospective trial. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 32:2228–2232. https://doi.org/10.1016/j.arthro.2016.03.026 CrossRef

Gomoll AH, Pappas G, Forsythe B, Warner JJP (2008) Individual skill progression on a virtual reality simulator for shoulder arthroscopy: a 3-year follow-up study. Am J Sports Med 36:1139–1142. https://doi.org/10.1177/0363546508314406 CrossRefPubMed

10.

Henn RF, Shah N, Warner JJP, Gomoll AH (2013) Shoulder arthroscopy simulator training improves shoulder arthroscopy performance in a cadaveric model. Arthrosc J Arthrosc Relat Surg Off Publ Arthrosc Assoc N Am Int Arthrosc Assoc 29:982–985. https://doi.org/10.1016/j.arthro.2013.02.013 CrossRef

11.

Moglia A, Ferrari V, Morelli L et al (2014) Distribution of innate ability for surgery amongst medical students assessed by an advanced virtual reality surgical simulator. Surg Endosc 28:1830–1837. https://doi.org/10.1007/s00464-013-3393-6 CrossRefPubMed

12.

Tofte JN, Westerlind BO, Martin KD et al (2017) Knee, shoulder, and fundamentals of arthroscopic surgery training: validation of a virtual arthroscopy simulator. Arthrosc J Arthrosc Relat Surg off Publ Arthrosc Assoc N am Int Arthrosc Assoc 33:641–646.e3. https://doi.org/10.1016/j.arthro.2016.09.014 CrossRef

13.

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 Off J ESSKA 23:3436–3442. https://doi.org/10.1007/s00167-014-3101-7 CrossRef

14.

Rahm S, Germann M, Hingsammer A et al (2016) Validation of a virtual reality-based simulator for shoulder arthroscopy. Knee Surg Sports Traumatol Arthrosc Off J ESSKA 24:1730–1737. https://doi.org/10.1007/s00167-016-4022-4 CrossRef

15.

Sudario-Lumague R, Chiang Y-C, Lin T-S (2018) Gender comparison of medical student microsurgical skills in a laboratory model. J Reconstr Microsurg. https://doi.org/10.1055/s-0038-1626694

16.

Ali A, Subhi Y, Ringsted C, Konge L (2015) Gender differences in the acquisition of surgical skills: a systematic review. Surg Endosc 29:3065–3073. https://doi.org/10.1007/s00464-015-4092-2 CrossRefPubMed

17.

(2013) Chiffres clés de la parité dans l’enseignement supérieur et la recherche. https://cache.media.enseignementsup-recherche.gouv.fr/file/Charte_egalite_femmes_hommes/90/6/Chiffres_parite_couv_vdef_239906.pdf

18.

Sneider JT, Hamilton DA, Cohen-Gilbert JE et al (2015) Sex differences in spatial navigation and perception in human adolescents and emerging adults. Behav Process 111:42–50. https://doi.org/10.1016/j.beproc.2014.11.015 CrossRef

19.

Schoenfeld R, Lehmann W, Leplow B (2010) Effects of age and sex and mental rotation and spatial learning from virtual environments. J Individ Differ 31(2):78–82. https://doi.org/10.1027/1614-0001/a00001

20.

Kimura D, Hampson E (1994) Cognitive pattern in men and women is influenced by fluctuations in sex hormones. Curr Dir Psychol Sci 3(2):57–61. https://doi.org/10.1111/1467-8721

21.

Kromann CB, Jensen ML, Ringsted C (2011) Test-enhanced learning may be a gender-related phenomenon explained by changes in cortisol level. Med Educ 45:192–199. https://doi.org/10.1111/j.1365-2923.2010.03790.x CrossRefPubMed

22.

Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J (2003) Impact of hand dominance, gender, and experience with computer games on performance in virtual reality laparoscopy. Surg Endosc 17:1082–1085. https://doi.org/10.1007/s00464-002-9176-0 CrossRefPubMed

23.

Schueneman AL, Pickleman J, Freeark RJ (1985) Age, gender, lateral dominance, and prediction of operative skill among general surgery residents. Surgery 98:506–515PubMed

24.

Adam JJ, Paas FG, Buekers MJ et al (1999) Gender differences in choice reaction time: evidence for differential strategies. Ergonomics 42:327–335. https://doi.org/10.1080/001401399185685 CrossRefPubMed

25.

Schlickum M, Hedman L, Felländer-Tsai L (2016) Visual-spatial ability is more important than motivation for novices in surgical simulator training: a preliminary study. Int J Med Educ 7:56–61. https://doi.org/10.5116/ijme.56b1.1691 CrossRefPubMedPubMedCentral

Title: Evaluation of arthroscopic skills with a virtual reality simulator in first-year orthopaedic residents
Authors: P. Walbron
H. Common
H. Thomazeau
F. Sirveaux
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Arthroscopy
Arthroscopy
Published in: International Orthopaedics / Issue 5/2020
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04520-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Evaluation of arthroscopic skills with a virtual reality simulator in first-year orthopaedic residents

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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