Factors Impacting Initial Arthroscopy Performance and Skill Progression in Novice Trainees

Area of Science:

• Orthopaedic Surgery
• Medical Education
• Surgical Simulation

Background:

• Arthroscopy is a fundamental skill in orthopaedic residency.
• Previous research on factors influencing arthroscopy performance has yielded conflicting results.
• Some trainees struggle to improve on arthroscopy simulators despite training.

Purpose of the Study:

• To identify trainee characteristics impacting initial arthroscopy skill and performance.
• To identify trainee characteristics affecting improvement through arthroscopy simulator training.

Main Methods:

• Forty-three medical students with no prior arthroscopy experience performed a virtual reality knee arthroscopy.
• Demographic, sports, gaming, and surgical experience data were collected.
• A subgroup trained on a non-anatomic simulator and was retested to assess learning curves.

Main Results:

• Initial arthroscopy performance weakly correlated with 3D video game experience (r=0.29).
• Trainees with prior sports experience requiring hand-eye coordination showed significant improvement in time and camera path length after training.
• Fourth-year medical students demonstrated the most significant improvement in procedure time post-training.

Conclusions:

• 3D video game experience shows a minimal correlation with baseline arthroscopy performance.
• Participation in sports requiring hand-eye coordination is a stronger predictor of learning and improvement on arthroscopy simulators.
• These findings can inform selection and training strategies for surgical residents.