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Augmented Reality Simulation Can Be Implemented to Successfully Teach Interns Arthroscopy
Alex M Meyer1, Ryan Serbin2, Eric Davis3
1Department of Orthopedic Surgery Duke University Medical Center Durham North Carolina U.S.A.
Purpose:
To develop and implement a simulation-based arthroscopy curriculum for orthopaedic surgery interns to be completed during their required orthopaedic intern skills month and to evaluate its effectiveness, feasibility, and impact on resident confidence.
Methods:
Twenty-one first year residents prospectively completed arthroscopic skill evaluation using VirtaMed augmented reality surgical simulator for the Fundamentals of Arthroscopy Surgical Training (FAST), shoulder, and knee models. Participants then completed the self-confidence score for surgical trainees survey. Then, they completed simulation training modules on each model over the course of their 1-month intern skills rotation. Each module contained 13-14 exercises. Following training, skill evaluations were repeated for each module and self-confidence survey was repeated.
Results:
One hundred percent of eligible participants were enrolled, and 100% completed the curriculum. Participant performance improved for all 3 modules (FAST, knee, shoulder). In the FAST modules, pretest to posttest scores for image centering improved from 64.1% to 95.5% (P < .001), and triangulation and probing improved from 73.5% to 88.4% (P = .019). In the knee modules, performance improved on diagnostic arthroscopy from 49.9% to 88.8% (P = .003) and on loose body removal from 40.0% to 75.3% (P < .001). In the shoulder modules, performance improved on the diagnostic arthroscopy from 89.9% to 98.9% (P = .011) and for loose body removal from 77.8% to 95.2% (P = .002). Self-confidence scale improved from 15.4 to 21.2 (P < .001). Acceptability of intervention measure, intervention appropriateness measure, and feasibility of intervention was 4.8, 4.6, and 4.7 respectively. Total self-paced time to completion was 4.9 h for all 3 sections. The shoulder took the most time (1.8 hours), followed by the knee (1.6 hours) and FAST (1.5 hours).
Conclusions:
The proposed arthroscopy simulation curriculum showed improvement in speed and skill on the arthroscopy simulator and improved personal confidence for orthopaedic surgery interns. It was able to be completed in less than 5 hours with 100% completion rate.
Clinical Relevance:
Arthroscopy is an essential skill for orthopaedic surgery residents. High-fidelity simulation is effective at teaching these skills in a safe and controlled environment.
