Learning the skills needed to perform shoulder arthroscopy by simulation

Marcheix, Pierre-Sylvain; Vergnenegre, Guillaume; Dalmay, François; Mabit, C.; Charissoux, J.-L.

doi:10.1016/j.otsr.2017.02.008

Cited by 27 publications

(9 citation statements)

References 14 publications

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“…Finally, we agree with the notion that simulation training can help to acquire the skills needed to perform the surgical procedure, such as hand-eye coordination, and the ability to work in 3 dimensions based on 2-dimensional visual information and haptic feedback (Akhtar et al 2016, Marcheix et al 2017. VR simulation is currently neither suited to teaching the participants the entire procedure including reposition of the fracture and soft-tissue handling nor does it encompass the overwhelming complexity of performing the procedure in the operating theatre.…”

Section: Need For Continued Clinical Supervision and Monitoringsupporting

confidence: 65%

HipSim — hip fracture surgery simulation utilizing the Learning Curve–Cumulative Summation test (LC-CUSUM)

2020

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Background and purpose — Virtual reality simulation of hip fracture surgery is available for orthopedic residents nationwide in Denmark. Summative assessment of learning applying the learning curve cumulative summation test (LC-CUSUM) has not been utilized in orthopedic simulation training. The strength of the LC-CUSUM is that it assumes incompetency and signals competency based on solid statistics. We investigated the LC-CUSUM characteristics of novices stepwise mastering the simulated dynamic hip screw (DHS) procedure. Material and methods — 32 1st-year orthopedic residents participated in HipSim and its 3 subsequent LC-CUSUM evaluations: placing a Kirschner wire, placing a Kirschner wire in different patients, and performing the entire DHS procedure in different patients. The career status of the participants, i.e., still working in orthopedics or in another specialty was recorded ≥ 2 years after participation and associated with the simulation performance (passed/failed). Results — 13/14 participants passing HipSim according to LC-CUSUM were still working in orthopedics, while 9/18 participants failing HipSim had quit orthopedics at ≥ 2 years follow-up. The simulator-generated feedback did not statistically significantly differ between the groups. Interpretation — LC-CUSUM and its summative pass/fail assessment of each simulation was feasible in this formative simulation program. Clinical educators can be reassured that participants passing HipSim are likely to continue to 2nd–5th year of residency, while failing HipSim should raise concerns and trigger career counselling and clinical supervision. The motivational aspect of LC-CUSUM pass/fail assessment when designing formative simulation training warrants further research.

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Section: Need For Continued Clinical Supervision and Monitoringsupporting

confidence: 65%

HipSim — hip fracture surgery simulation utilizing the Learning Curve–Cumulative Summation test (LC-CUSUM)

2020

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“…It has been previously commented that simulation training allows a learner to learn the skills required to perform arthroscopy but does not teach the learner the procedure itself. 22 Frank et al 23 comment on the numerous essential skills that simulation training fails to train in any manner, such as portal placement and fluid management. Safety during the surgical procedure may also be difficult to train on the simulator.…”

Section: Discussionmentioning

confidence: 99%

Module-Based Arthroscopic Knee Simulator Training Improves Technical Skills in Naive Learners: A Randomized Trial

Beaudoin

Larrivée

McRae

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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To compare the effectiveness, in comparison to a control group (C), of module-based training (MBT) and traditional learning (TL) as a means of acquiring arthroscopic skills on an arthroscopic surgery simulator. Methods: Thirty health sciences students with no previous arthroscopy experience were recruited and randomized into 1 of 3 groups: MBT, TL, or C (1:1:1 ratio). Participants in MBT were required to independently practice on a VirtaMed ArthroS simulator (VirtaMed AG, Zurich, Switzerland) for a minimum of 2 hours per week, whereas TL received one-on-one coaching by a senior orthopaedic resident for 15 minutes per week. The control group received no training. All groups were assessed at baseline and at 4 weeks based on objective measures generated by the surgical simulator (procedure time, camera path length, meniscus cutting score, detailed visualization, safety score and total score), and subjective ratings scales (Objective Assessment of Arthroscopic Skill [OAAS] global assessment form, and Competency-Based Assessment form). Results: Participants in the MBT group trained on average 113 min/week whereas the TL group trained on average 24 min/week. Three-way repeated-measures analysis of variance showed significant group by time interactions for procedure time (P ¼ .006), camera path length (P ¼ .008), safety score (P ¼ .013), total score (P ¼ .003), OAAS form (P < .001), and Competency-Based Assessment form (P < .001). MBT group was superior to C group for procedure time (P ¼ .02), camera path length (P ¼ .003), total score (P ¼ .004), and OAAS form (P ¼ .021), but there were no significant post-hoc differences between MBT and TL groups, or TL and C groups after Bonferroni correction. Total practice time explained 37.5% of the final simulator total score variance. Conclusions: Knee arthroscopy simulation training with self-learning modules can improve skills in areas such as procedure time, camera path length, and total score in untrained participants compared with a control group. Clinical Relevance: Module-based simulation training provides additional training time and improves technical skills in naive health science students. It is hoped that this effect can be preserved and applied to junior resident developing in a busy residency program.

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“…Previous literature suggested that the learning of skills in itself is more important than the actual simulator model to learn a specific procedure. 26,27 Although this type of proficiency-based learning is proven to be effective, literature published about simulation training focused on the simulator model itself and fewer studies were about the transferability of simulator training to a real patient.…”

Section: Fidelitymentioning

confidence: 99%

Teaching hip surgery to orthopaedic residents: what’s new?

2020

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Purpose: The purpose of this study is to provide an overview of the published literature on the existing educational methods used to teach surgical skills, with a specific focus on hip surgery, to orthopaedic residents. Methods: A total of 31 articles were selected from a PubMed literature search on the topic of teaching surgical skills to orthopaedic residents, and 9 articles on hip surgery are included in this review. Results: Although several methods are included in the published literature to teach orthopaedic residents, only arthroscopy of the knee and shoulder joint is well described. Hip arthroscopy has a steeper learning curve and thus the use of simulation training as a complementary teaching method is even more important. Conclusions: Currently, open surgery skills for joint arthroplasty are largely acquired by apprenticeship learning. Simulation training in the form of virtual reality could contribute to better performance of residents, decreasing operation time and improving patient safety.

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Learning the skills needed to perform shoulder arthroscopy by simulation

Abstract: III-case-control study.

Cited by 27 publications

References 14 publications

HipSim — hip fracture surgery simulation utilizing the Learning Curve–Cumulative Summation test (LC-CUSUM)

HipSim — hip fracture surgery simulation utilizing the Learning Curve–Cumulative Summation test (LC-CUSUM)

Module-Based Arthroscopic Knee Simulator Training Improves Technical Skills in Naive Learners: A Randomized Trial

Teaching hip surgery to orthopaedic residents: what’s new?

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