Validation of a virtual reality-based simulator for shoulder arthroscopy

Rahm, Stefan; Germann, Marco; Hingsammer, Andreas; Wieser, Karl; Gerber, Christian

doi:10.1007/s00167-016-4022-4

Cited by 41 publications

(38 citation statements)

References 43 publications

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“…The studies were broadly split into 3 categories: studies measuring the impact of a simulation training intervention (26 studies 6 - 31 ), studies assessing the construct validity of a simulator designed for training surgeons (42 studies 32 - 73 ), and studies validating an assessment tool (37 studies 74 - 110 ) (see Appendix Tables 1 and 2, column 1). Of the included studies, 60% assessed arthroscopic skill involving the knee (34 studies) 6 , 8 , 9 , 13 , 15 , 17 , 19 , 31 - 33 , 36 , 38 , 39 , 41 , 42 , 47 , 48 , 54 - 56 , 63 , 74 , 75 , 77 - 83 , 86 , 87 , 89 , 91 , the shoulder (25 studies) 7 , 12 , 15 , 16 , 18 , 20 , 37 , 40 , 44 , 45 , 49 , 51 , 53 , 54 , 56 , 63 , 76 , 77 , 81 , 82 , 88 , 90 - 92 , 110 , the hip (3 studies) 43 , 50 , 85 , the ankle (1 study) 14 , and basic general arthroscopic skills (6 studies)…”

Section: Resultsmentioning

confidence: 99%

“…Hand-motion analysis can generate a sophisticated data profile that can detect subtle improvement in surgical performance, and may be able to measure the attainment of mastery. Other motion parameters, such as gaze tracking 6 , triangulation time 74 , instrument path length 12 , 15 , 40 , 48 , 49 , 51 , 55 , 56 , 63 , 110 , and collisions 38 , 55 , have demonstrated construct validity and feasibility in the simulated environment but are unlikely to be useful in the live operative theater, as most of these measurements are derived from the simulator itself.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Tools Used in Assessing Technical Skills and Operative Competence in Trauma and Orthopaedic Surgical Training

et al. 2020

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Background: Robust assessment of skills acquisition and surgical performance during training is vital to ensuring operative competence among orthopaedic surgeons. A move to competency-based surgical training requires the use of tools that can assess surgical skills objectively and systematically. The aim of this systematic review was to describe the evidence for the utility of assessment tools used in evaluating operative performance in trauma and orthopaedic surgical training. Methods: We performed a comprehensive literature search of MEDLINE, Embase, and Google Scholar databases to June 2019. From eligible studies we abstracted data on study aim, assessment format (live theater or simulated setting), skills assessed, and tools or metrics used to assess surgical performance. The strengths, limitations, and psychometric properties of the assessment tools are reported on the basis of previously defined utility criteria. Results: One hundred and five studies published between 1990 and 2019 were included. Forty-two studies involved open orthopaedic surgical procedures, and 63 involved arthroscopy. The majority (85%) were used in the simulated environment. There was wide variation in the type of assessment tools in used, the strengths and weaknesses of which are assessor and setting-dependent. Conclusions: Current technical skills-assessment tools in trauma and orthopaedic surgery are largely procedure-specific and limited to research use in the simulated environment. An objective technical skills-assessment tool that is suitable for use in the live operative theater requires development and validation, to ensure proper competency-based assessment of surgical performance and readiness for unsupervised clinical practice. Clinical Relevance: Trainers and trainees can gain further insight into the technical skills assessment tools that they use in practice through the utility evidence provided.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of Tools Used in Assessing Technical Skills and Operative Competence in Trauma and Orthopaedic Surgical Training

et al. 2020

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“…Multiple studies have demonstrated the construct validity of simulators by showing a correlation between a surgeon's experience and their performance on a simulator. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The procedures where this has been reported include diagnostic and therapeutic knee, hip and shoulder arthroscopy, hip fracture fixation, the fixation of complex intra-articular fractures and basic orthopaedic skills, including drilling (Table II). Studies assessing learning curves.…”

Section: Resultsmentioning

confidence: 99%

Does virtual reality simulation have a role in training trauma and orthopaedic surgeons?

Lawrence

et al. 2018

The Bone & Joint Journal

110

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The demonstration of 'real-world' benefits from the use of VR simulation in knee and shoulder arthroscopy is promising. However, evidence supporting its utility in other forms of orthopaedic surgery is lacking. Further studies of validity and utility should be combined with robust analyses of the cost efficiency of validated simulators to justify the financial investment required for their use in orthopaedic training. Cite this article: Bone Joint J 2018;100-B:559-65.

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“…For this reason, institutions and areas such as orthopedics, which understand the need to implement the simulation in their curriculum program design their own simulators, as is the case of arthroscopy simulators and virtual reality programs; however, they must be validated to demonstrate that their design and applicability recreate situations similar to the real ones and that the appropriate process of meaningful learning takes place. [13][14][15][16][17][18][19] Another use of clinical simulation within the orthopedic area is to classify the level of competence of different procedures performed by physicians through performance metrics that precisely define the performance threshold, opening the possibility of using the simulation to evaluate or certifying the level of competence. 20,21 These are lots of simulation approaches in orthopedics; although it is known that orthopedic education in the postgraduate area has great relevance, within the area of undergraduate general medical training is limited, and the evidence found regarding competencies in orthopedics, existing reports show that they lack the skills needed to diagnose, treat or to refer to the specialist.…”

Section: Discussionmentioning

confidence: 99%

The simulation in health care in orthopedics

Sánchez¹,

Cortés²,

López³

et al. 2019

MOJOR

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The changes in education, secondary to the demand for health care in the 21 st century, have exploited different strategies to improve the quality of training of health professionals, simulation in health care has had a boom in recent decades and the branch of Orthopedics has not been exempt. There are different approaches that can be reached with simulation in orthopedics, from simulation management and simulators or virtual reality programs to influence the learning curve and improve technical and non-technical skills, classify the level of those skills, assess and certify professional competencies, among others. Most studies in orthopedics focus on surgical areas, leaving aside the approach of clinical and non-technical skills, as well as undergraduate, so one of the challenges of simulation within the area of orthopedics is to expand the vision towards these areas, since it has been demonstrated that at all levels, the simulation generates significant improvements in the training and performance of health personnel, generating a direct impact on patient safety.

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Validation of a virtual reality-based simulator for shoulder arthroscopy

Abstract: II.

Cited by 41 publications

References 43 publications

Analysis of Tools Used in Assessing Technical Skills and Operative Competence in Trauma and Orthopaedic Surgical Training

Analysis of Tools Used in Assessing Technical Skills and Operative Competence in Trauma and Orthopaedic Surgical Training

Does virtual reality simulation have a role in training trauma and orthopaedic surgeons?

The simulation in health care in orthopedics

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