Effect of simulator fidelity on skill acquisition and trainee satisfaction in arthroscopic surgery training for...

In recent years, simulator-based training has gained attention as a safe and effective approach for surgical education. In orthopedic surgery, simulators for arthroscopic procedures, which require extensive practice to master, have been developed and shown to benefit clinical performance. This study aimed to evaluate the effectiveness of 2 types of arthroscopy simulators in medical education by assessing medical students without prior surgical training.

We prospectively and randomly evaluated the effectiveness and satisfaction of arthroscopy simulators using 2 devices: a high-fidelity virtual reality simulator (ArthroSim) and a low-fidelity simulator (AZBOTS). To assess simulator effectiveness, 28 first-year medical students received 90 min of training on either device. Their knee arthroscopy skills, including tasks such as visualizing and probing the medial compartment and cruciate ligaments, were assessed using ArthroSim. Skill acquisition was measured by procedure completion time and the Arthroscopic Surgery Skill Evaluation Tool Global Rating Scale. Additionally, to assess trainee satisfaction, 109 fifth-year medical students completed a 7-point Likert scale questionnaire evaluating spatial judgment, hand-eye coordination, camera navigation, instrument handling, and the overall knee arthroscopy training experience.

No significant differences in skill acquisition were observed between the 2 simulator groups. Likewise, there were no significant differences in total questionnaire scores or in spatial judgment, hand-eye coordination, and camera navigation. However, participants using the high-fidelity simulator reported significantly greater satisfaction with instrument handling (p = 0.024) and the overall knee arthroscopy training experience (p = 0.033).

Although skill acquisition did not differ significantly between the high- and low-fidelity simulators after a single training session, the high-fidelity simulator markedly improved trainee satisfaction, especially in instrument handling and perceived quality of the training experience. These findings suggest that simulator fidelity enhances the educational value of the arthroscopic training for novices emphasizing the role of realistic simulation in early surgical education.