Construct Validity and Experience of Using a Low-cost Arthroscopic Knee Surgery Simulator

Milcent, Paul André Alain; Kulcheski, Álynson Larocca; Rosa, Fernando Martins; Dau, Leonardo; Filho, Edmar Stieven

doi:10.1016/j.jsurg.2020.06.007

Cited by 7 publications

(16 citation statements)

References 31 publications

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“…The greater the surgeon's expertise, the better the clinical results, 7 the greater the precision of the gestures, 8 9 10 11 and the shorter the operating time. 12 13 14 Our results are in line with those reported in the literature regarding operative time. Overall, the PII or PV duration was inversely proportional to the surgeon's level of expertise during minimally invasive osteosynthesis of distal radius fractures.…”

Section: Discussionsupporting

confidence: 91%

Influence of Surgeon's Expertise on the Duration of Approach and Closure during Osteosynthesis of Distal Radius Fractures

Cafarelli,

Graëff,

Lampert

et al. 2024

J Wrist Surg

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Background The aim of this study was to determine whether the duration of the approach (PII) and closure (PV) phases for minimally invasive plate osteosynthesis (MIPO) of distal radius fractures varied according to the surgeon's level of expertise. The main hypothesis was that the PII or PV duration was inversely proportional to the level of expertise. Methods The method measured the duration of PII and PV for 50 videos of MIPO operated by one surgeon with level 3E expertise, three with level 4E, and one with level 5E. The videos were viewed to identify any technical errors. Results The average PII duration was 3 minutes 8 seconds for level 5E, 4 minutes 7 seconds for 4E, and 6 minutes 19 seconds for 3E. Average PV duration was 2 minutes 12 seconds for level 5E, 2 minutes 36 seconds for 4E, and 2 minutes 41 seconds for 3E. The average duration of PII + PV was 5 minutes 20 seconds for level 5E, 6 minutes 37 seconds for 4E, and 9 minutes for 3E. These findings indicate that both PII and PV duration was the longest in the level 3E surgeons' practice. Six technical errors were identified for levels 3E and 4E during PII (hemostasis control, multiple incisions, instrument handling, improper use of the fluoroscope, time-outs) and PV (intradermal reattachment). Clinical Relevance The main hypothesis was verified since the duration of PII or PV was inversely proportional to the surgeon's level of expertise. This study identified technical errors in hand surgery practices of new surgeons. By early identification and correcting these minor errors, it would be possible to speed up the learning curve. We recommend surgical videos to be systematically recorded and analyzed to improve hand surgery practices. Type of Study/Level of Evidence Therapeutic/Level IIIa.

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Section: Discussionsupporting

confidence: 91%

Influence of Surgeon's Expertise on the Duration of Approach and Closure during Osteosynthesis of Distal Radius Fractures

Cafarelli,

Graëff,

Lampert

et al. 2024

J Wrist Surg

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“…The simulator in the present study also used accessible materials, but we opted for an opaque plastic mannequin so that the participant could only access internal structures through the endoscopic camera. in the inexperienced group 18,27,28 .…”

Section: Discussionmentioning

confidence: 97%

“…Sample size calculation was based on the analysis of the power of statistical tests 17 .The sample size was calculated based on previous studies with the same methodology that used the standard deviation of the variable ‘time’ to detect differences in the magnitude of 1.05 standard deviation between the groups, with 80% power and 95% confidence level 18 .…”

Section: Methodsmentioning

confidence: 99%

“…Analytical statistics of objective visual parameters. used the standard deviation of the variable 'time' to detect differences in the magnitude of 1.05 standard deviation between the groups, with 80% power and 95% confidence level18 .The significance level was set at 5%. All analyses were performed in Microsoft Excel® (2013) and R® 3.4.4 (R Foundation for Statistical Computing Vienna, Austria).…”

mentioning

confidence: 99%

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Validation of an endoscopic flavectomy training model

Kulcheski

Filho

Nunes

et al. 2021

Rev. Col. Bras. Cir.

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Objective: to validate a lumbar spine endoscopic flavectomy simulator using the construct method and to assess the acceptability of the simulator in medical education. Methods: thirty medical students and ten video-assisted surgery experienced orthopedists performed an endoscopic flavectomy procedure in the simulator. Time, look-downs, lost instruments, respect for the stipulated edge of the ligamentum flavum, regularity of the incision, GOALS checklist (Global Operative Assessment of Laparoscopic Skills), and responses to the Likert Scale adapted for this study were analyzed. Results: all variables differed between groups. Procedure time was shorter in the physician group (p < 0.001). Look-downs and instrument losses were seven times greater among students than physicians. Half of the students respected the designated incision limits, compared to 80% of the physicians. In the student group, about 30% of the incisions were regular, compared to 100% in the physician group (p < 0.001). The physicians performed better in all GOALS checklist domains. All the physicians and more than 96% of the students considered the activity enjoyable, and approximately 90% believed that the model was realistic and could contribute to medical education. Conclusions: the simulator could differentiate the groups’ experience level, indicating construct validity, and both groups reported high acceptability.

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“…21 The item with the greatest disagreement was whether the simulator could replace cadaver training, with 30% of disagreement between surgeons and residents, while 20% of students disagreed, corresponding to the findings of other authors. 28,30 The cadaver remains the gold standard for simulation, providing identical anatomy, similar tactile sensation, limited only by the lack of bleeding and active muscle contraction.…”

Section: Discussionmentioning

confidence: 99%

Validação de constructo e experiência de uso de um simulador de artroscopia de ombro de baixo custo

Dau,

Almeida,

Kulcheski

et al. 2023

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Validar o modelo de baixo custo para treinamento em artroscopia e analisar a aceitação e utilidade do simulador desenvolvido no ensino e treinamento médico. Método Dez acadêmicos do curso de medicina, dez residentes do terceiro ano em ortopedia e dez cirurgiões de ombro realizaram tarefas pré determinadas em um simulador de ombro duas vezes. Os parâmetros utilizados foram o tempo para completar as tarefas, quantidade de olhares para as mãos, escore de GOALS (Global Operative Assessment of Laparoscopic Skills) e comparados entre os grupos e intragrupos. Uma escala de Likert adaptada foi aplicada abordando as impressões dos indivíduos acerca do simulador e de sua aplicabilidade. Resultados Na comparação intergrupos, os cirurgiões de ombro tiveram melhores escores e tempos que os demais grupos. Quando as tarefas foram repetidas, o grupo de cirurgiões, teve uma melhora de 59% no tempo (p < 0,05), assim como no grupo de acadêmicos. No escore de GOALS os cirurgiões de ombro apresentaram escores consistentemente melhores que os demais grupos. E quando avaliamos a evolução do primeiro para o segundo teste, o grupo de cirurgiões e o grupo de acadêmicos tiveram melhora estatisticamente significante (p < 0,05). No quesito de lookdowns houve diminuição em todos os grupos. Houve consenso em que o simulador é útil no treinamento. Conclusão O simulador desenvolvido permitiu a diferenciação entre indivíduos com diferentes níveis de treinamento em cirurgia artroscópica. Foi aceito por 100% dos participantes como uma ferramenta útil no treinamento cirúrgico artroscópico do ombro.

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Construct Validity and Experience of Using a Low-cost Arthroscopic Knee Surgery Simulator

Cited by 7 publications

References 31 publications

Influence of Surgeon's Expertise on the Duration of Approach and Closure during Osteosynthesis of Distal Radius Fractures

Influence of Surgeon's Expertise on the Duration of Approach and Closure during Osteosynthesis of Distal Radius Fractures

Validation of an endoscopic flavectomy training model

Validação de constructo e experiência de uso de um simulador de artroscopia de ombro de baixo custo

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