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Shoulder Arthroscopy Simulator Training Improves Shoulder Arthroscopy Performance in a Cadaver Model (SS-60)
ABSTRACTS
highest grades for knot tying, suture passing, anchor placement, and scope mechanics with the models, with the lowest grades for portal creation, lack of fluid within the joint, and overall replication of surgery. The differences between the highest and lowest scores were statistically significant (p < 0.05). Similar findings were observed for the experienced surgeons. Conclusion: The results of this study indicate that while the use of the models seemed the most acceptable for motor skills training within the joint, the models were felt to be less acceptable for portal creation and overall surgery replication. These results would indicate that there are two important components to arthroscopic skills training: portal creation and motor-skills, and both should be addressed in laboratory teaching. The expense, inconsistency of cadaver tissue, and the rules associated with the use of human tissue makes model use attractive. In our study, both student surgeons and experienced shoulder arthroscopists both felt that the models were adequate for motor-skills training for both Bankart reconstruction and rotator cuff repair. Shoulder Arthroscopy Simulator Training Improves Shoulder Arthroscopy Performance in a Cadaver Model (SS-60) R. FRANK HENN, M.D., PRESENTING AUTHOR NEEL SHAH, M.D. JON J. P. WARNER, M.D. ANDREAS GOMOLL, M.D. Introduction: The benefits of simulator training on actual performance of shoulder arthroscopy are unknown. The goal of this study was to quantify the benefits of shoulder arthroscopy simulator training with a cadaver model of shoulder arthroscopy. We hypothesized that simulator training would improve shoulder arthroscopy performance. Methods: Seventeen first year medical students with no prior experience in shoulder arthroscopy were enrolled and completed this study. Each subject completed a baseline proctored arthroscopy on a cadaveric shoulder, which included controlling the camera and completing a standard series of tasks using the probe. The subjects were randomized, and nine of the subjects received training on a virtual reality simulator for shoulder arthroscopy. All subjects then repeated the same cadaveric arthroscopy. The arthroscopic videos were analyzed in a blinded fashion for time to task completion and subjective assessment of technical performance. The two groups were compared with students t-tests, and change over time within groups was analyzed with paired t-tests. Results: There were no observed differences between the two groups on the baseline evaluation. The simulator group improved significantly from baseline with respect to time to completion and subjective performance (p<0.05). Time to completion was significantly faster in the simulator group compared to controls at final evaluation (p<0.05). Conclusion: Shoulder arthroscopy simulator training resulted in significant benefits in clinical shoulder arthroscopy performance in this cadaver model. This study suggests that there may be a role for simulator training in shoulder arthroscopy education.
e29
Arthroscopic Shoulder Simulation: Can a Computer Perceive Expertise? (SS-61) ERIC FERKEL, M.D., PRESENTING AUTHOR CONNOR LAROSE, M.D. GEORGE HATCH III, M.D. STEPHEN J. SYNDER, M.D. JAMES C. ESCH, M.D. Introduction: It is imperative for orthopaedic surgeons to develop and retain arthroscopic surgical skills to maintain peak performance levels. As new surgical simulators begin to become more commonplace in training there is a need to validate the model’s scoring system in perception of expertise of the user. The purpose of this study was to evaluate the biometric scoring system of a virtual reality arthroscopic simulator (ArthroVR [Simbionix USA Corporation/GMV, Cleveland, OH]) in respect to whether scores were accurate reflections of the experience of the surgeon. Methods: 41 subjects of various levels of arthroscopic shoulder experience including residents, fellows and attending surgeons were recruited to participate in this study. Each subject completed two different simulator tasks on the Arthro VR simulator. The participants were asked to do two tasks, a Bankart screw placement and a basic probe exam. All participants were asked their years of clinical practice, number of shoulder arthroscopies performed per year and their level of simulator experience. A global score was assigned for each exam based on the biometric scoring system built into the simulator. Results: In both the probe exam and Bankart screw placement there was a 0.025 and 0.175 Pearson correlation coefficient, respectively, between the number of years in practice and the total score. There was a 0.207 and 0.323 correlation with the scoring on the probe exam and Bankart screw placement with number of scopes done in a year. Conclusion: This study questions the validity of the metrics used by the ArthroVR scoring system in its role in evaluation of the surgeon. In addition, this study questions its use as a measurement device in future studies. The post-test questionnaire showed that the participants felt that the simulator provided realistic haptic feedback and the instrument usage and motion were realistic. The results indicate a need for a better metrics-scoring model in the virtual arthroscopy simulator model as we increasingly use the simulators to assess residents and fellows and evaluate progress in mastering techniques in arthroscopic surgery. It is notable that the simulator is an important tool in arthroscopy training and we must continue to utilize it is as a way to prepare resident and fellows. Computer-Mentored Training in Knee Arthroscopy is Equivalent to Training-as-Usual: A Pilot Randomized Controlled Trial (SS-62) JEFFREY LEITER, M.SC., PH.D., PRESENTING AUTHOR JESSE SLADE SHANTZ, M.D. PETER MACDONALD, M.D. Introduction: This study aimed to determine the efficacy of arthroscopic skills training employing a knee simulator with computer mentor.
highest grades for knot tying, suture passing, anchor placement, and scope mechanics with the models, with the lowest grades for portal creation, lack of fluid within the joint, and overall replication of surgery. The differences between the highest and lowest scores were statistically significant (p < 0.05). Similar findings were observed for the experienced surgeons. Conclusion: The results of this study indicate that while the use of the models seemed the most acceptable for motor skills training within the joint, the models were felt to be less acceptable for portal creation and overall surgery replication. These results would indicate that there are two important components to arthroscopic skills training: portal creation and motor-skills, and both should be addressed in laboratory teaching. The expense, inconsistency of cadaver tissue, and the rules associated with the use of human tissue makes model use attractive. In our study, both student surgeons and experienced shoulder arthroscopists both felt that the models were adequate for motor-skills training for both Bankart reconstruction and rotator cuff repair. Shoulder Arthroscopy Simulator Training Improves Shoulder Arthroscopy Performance in a Cadaver Model (SS-60) R. FRANK HENN, M.D., PRESENTING AUTHOR NEEL SHAH, M.D. JON J. P. WARNER, M.D. ANDREAS GOMOLL, M.D. Introduction: The benefits of simulator training on actual performance of shoulder arthroscopy are unknown. The goal of this study was to quantify the benefits of shoulder arthroscopy simulator training with a cadaver model of shoulder arthroscopy. We hypothesized that simulator training would improve shoulder arthroscopy performance. Methods: Seventeen first year medical students with no prior experience in shoulder arthroscopy were enrolled and completed this study. Each subject completed a baseline proctored arthroscopy on a cadaveric shoulder, which included controlling the camera and completing a standard series of tasks using the probe. The subjects were randomized, and nine of the subjects received training on a virtual reality simulator for shoulder arthroscopy. All subjects then repeated the same cadaveric arthroscopy. The arthroscopic videos were analyzed in a blinded fashion for time to task completion and subjective assessment of technical performance. The two groups were compared with students t-tests, and change over time within groups was analyzed with paired t-tests. Results: There were no observed differences between the two groups on the baseline evaluation. The simulator group improved significantly from baseline with respect to time to completion and subjective performance (p<0.05). Time to completion was significantly faster in the simulator group compared to controls at final evaluation (p<0.05). Conclusion: Shoulder arthroscopy simulator training resulted in significant benefits in clinical shoulder arthroscopy performance in this cadaver model. This study suggests that there may be a role for simulator training in shoulder arthroscopy education.
e29
Arthroscopic Shoulder Simulation: Can a Computer Perceive Expertise? (SS-61) ERIC FERKEL, M.D., PRESENTING AUTHOR CONNOR LAROSE, M.D. GEORGE HATCH III, M.D. STEPHEN J. SYNDER, M.D. JAMES C. ESCH, M.D. Introduction: It is imperative for orthopaedic surgeons to develop and retain arthroscopic surgical skills to maintain peak performance levels. As new surgical simulators begin to become more commonplace in training there is a need to validate the model’s scoring system in perception of expertise of the user. The purpose of this study was to evaluate the biometric scoring system of a virtual reality arthroscopic simulator (ArthroVR [Simbionix USA Corporation/GMV, Cleveland, OH]) in respect to whether scores were accurate reflections of the experience of the surgeon. Methods: 41 subjects of various levels of arthroscopic shoulder experience including residents, fellows and attending surgeons were recruited to participate in this study. Each subject completed two different simulator tasks on the Arthro VR simulator. The participants were asked to do two tasks, a Bankart screw placement and a basic probe exam. All participants were asked their years of clinical practice, number of shoulder arthroscopies performed per year and their level of simulator experience. A global score was assigned for each exam based on the biometric scoring system built into the simulator. Results: In both the probe exam and Bankart screw placement there was a 0.025 and 0.175 Pearson correlation coefficient, respectively, between the number of years in practice and the total score. There was a 0.207 and 0.323 correlation with the scoring on the probe exam and Bankart screw placement with number of scopes done in a year. Conclusion: This study questions the validity of the metrics used by the ArthroVR scoring system in its role in evaluation of the surgeon. In addition, this study questions its use as a measurement device in future studies. The post-test questionnaire showed that the participants felt that the simulator provided realistic haptic feedback and the instrument usage and motion were realistic. The results indicate a need for a better metrics-scoring model in the virtual arthroscopy simulator model as we increasingly use the simulators to assess residents and fellows and evaluate progress in mastering techniques in arthroscopic surgery. It is notable that the simulator is an important tool in arthroscopy training and we must continue to utilize it is as a way to prepare resident and fellows. Computer-Mentored Training in Knee Arthroscopy is Equivalent to Training-as-Usual: A Pilot Randomized Controlled Trial (SS-62) JEFFREY LEITER, M.SC., PH.D., PRESENTING AUTHOR JESSE SLADE SHANTZ, M.D. PETER MACDONALD, M.D. Introduction: This study aimed to determine the efficacy of arthroscopic skills training employing a knee simulator with computer mentor.