Virtual reality assessment of technical skill using the Bonedoc DHS simulator

Area of Science:

• Orthopedic Surgery
• Surgical Simulation
• Medical Education Technology

Background:

• Hip fracture fixation is a common orthopedic procedure.
• Assessing surgical skill objectively is crucial for training.
• Virtual reality (VR) simulators offer a potential tool for surgical training and assessment.

Purpose of the Study:

• To evaluate the Bonedoc DHS virtual reality simulator's ability to discriminate between surgical experience levels in hip fracture fixation.
• To assess the simulator's effectiveness in differentiating novices from trainee surgeons.

Main Methods:

• Three groups (medical students, basic trainees, advanced trainees) performed virtual hip fracture fixation using the Bonedoc DHS simulator.
• Performance metrics included accuracy, operative time, and technical errors like screw penetration.
• Statistical analysis compared outcomes across experience groups.

Main Results:

• The simulator significantly differentiated between novices and trainee surgeons in accuracy, X-ray use, and speed (p<0.01, p<0.05).
• Medical students had significantly more intra-articular screw penetrations (12) compared to basic (6) and advanced trainees (2) (p<0.01).
• Advanced trainees showed higher accuracy and fewer X-rays, while basic trainees were faster but less accurate.

Conclusions:

• The Bonedoc DHS simulator is a viable tool for distinguishing between varying levels of surgical operative experience.
• VR simulation can provide objective feedback for orthopedic surgical training and skill assessment.
• The simulator aids in identifying areas for improvement in surgical technique for trainees.