Shoulder Arthroscopy Simulator Training Improves Surgical Procedure Performance: A Controlled Laboratory Study

Area of Science:

• Orthopaedic Surgery
• Surgical Simulation
• Medical Education

Background:

• Previous studies assessed dry lab (DL) or virtual reality (VR) simulation for arthroscopic tasks but not specific surgical procedures.
• This research bridges that gap by evaluating simulation's impact on arthroscopic anterior labral repair performance.

Purpose of the Study:

• To assess the effectiveness of a shoulder arthroscopy simulator program in enhancing performance of arthroscopic anterior labral repair.
• Hypothesized that both DL and VR simulation would improve performance, with VR being more effective based on the Arthroscopic Surgery Skill Evaluation Tool (ASSET) Global Rating Scale.

Main Methods:

• A controlled laboratory study involved 38 orthopaedic residents (PGYs 1-5) who completed a pretest cadaveric shoulder stabilization procedure.
• Residents were randomized into VR or DL simulation groups for a 4-week program, followed by a posttest.
• Performance was evaluated by grading procedural steps and using the ASSET Global Rating Scale.

Main Results:

• No significant pretest performance differences were observed between groups.
• Overall procedural step scores improved with combined simulator training (P = .0424), but not within individual groups.
• ASSET scores significantly improved in both DL (P = .0045) and VR (P = .0003) groups, with no significant difference between simulation types.

Conclusions:

• A 4-week simulation program effectively enhances arthroscopic skills and performance in specific surgical procedures like anterior labral repair.
• Both VR and DL simulation models demonstrated comparable effectiveness, disproving the hypothesis that VR would be superior.
• Simulator training offers a valuable tool for teaching arthroscopic skills and surgical procedures to both novice and experienced orthopaedic surgeons.