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ARTHRO Mentor Clinical Validations


The following abstract and poster were presented at annual American Academy of Orthopedic Surgeons meeting, AAOS, March 11-15, New Orleans, Louisiana

Transfer of Surgical Skills: the Importance of Arthrosimulation Training for Orthopaedic Surgery Residents

Marie Diane Isabelle Mousseau, cd, MDCM, MSc, Michelle Laprade, MD student, MSc,

Laurence Marck, MIng, Véronique Godbout, MD, MA, FRCSC

McGill Univesity, Universite de Montreal, Canada

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Shoulder arthroscopy simulator performance correlates with resident and shoulder arthroscopy experience.

Martin KD, Cameron K, Belmont PJ, Schoenfeld A, Owens BD.

William Beaumont Army Medical Center, El Paso, TX 79920, USA.

 J Bone Joint Surg Am. 2012 Nov 7;94(21):e160.

BACKGROUND: The technical skills required to perform arthroscopy are multifaceted and require supervised training and repetition. Obtaining this basic arthroscopic skill set can be costly and time-consuming. Simulation may represent a viable training source for basic arthroscopic skills. Our goal was to evaluate the correlation between timed task performance on an arthroscopic shoulder simulator and both resident experience and shoulder arthroscopy experience.

METHODS: Twenty-seven residents were voluntarily recruited from an orthopaedic residency program. Each subject was tested annually for three consecutive years on an arthroscopic shoulder simulator and objectively scored on time to completion of a standardized object localization task. Each subject’s total number of shoulder arthroscopies, all arthroscopies, and cases were calculated according to postgraduate year from their Accreditation Council for Graduate Medical Education (ACGME) case log. Generalized estimating equation multivariate regression analysis was performed to determine the correlation between simulation performance and total numbers of shoulder arthroscopies, all arthroscopies, and cases.

RESULTS: Univariate analyses revealed that postgraduate year, total number of shoulder arthroscopies, total number of arthroscopies of any joint, and total number of surgical cases performed during residency training prior to testing were associated with the mean time required to complete the simulator task. The number of prior shoulder arthroscopies performed (r = 0.55) and postgraduate year in training (r = 0.60) correlated most strongly with simulator basic task performance. In the multivariate analysis, the number of prior shoulder arthroscopies and postgraduate year remained independent predictors of faster completion of the simulator task. For every additional postgraduate year, there was a sixteen-second improvement in the time required to complete the simulator task (p < 0.005). Similarly, after controlling for the influence of postgraduate year, there was a twelve-second decrease in the time to complete the simulator task for every additional fifty shoulder arthroscopies performed during residency training (p < 0.008).

CONCLUSIONS: These results showed a significant relationship between performance of basic arthroscopic tasks in a simulator model and the number of shoulder arthroscopies performed. The data confirmed our hypothesis that simulator performance is representative of both resident experience and shoulder arthroscopy experience.

CLINICAL RELEVANCE: This study suggests that greater resident clinical experience and shoulder arthroscopy experience are both reflected in improved performance of basic tasks on a shoulder simulator. These findings warrant further investigation to determine if training on a validated arthroscopic shoulder simulator would improve clinical arthroscopic skills.

Full Article

 


 

Arthroscopic basic task performance in shoulder simulator model correlates with similar task performance in cadavers.

Martin KD, Belmont PJ, Schoenfeld AJ, Todd M, Cameron KL, Owens BD.

William Beaumont Army Medical Center, El Paso, TX 79920, USA.

J Bone Joint Surg Am. 2011 Nov 2;93(21):e1271-5.

BACKGROUND: Attainment of the technical skill necessary to safely perform arthroscopic procedures requires the instruction of orthopaedic surgery residents in basic arthroscopic skills. Although previous studies involving shoulder arthroscopy simulators have demonstrated a correlation between task performance and the level of prior arthroscopic experience, data demonstrating the correlation of simulator performance with arthroscopic skill in a surgical setting are scarce. Our goal was to evaluate the correlation between timed task performance in an arthroscopic shoulder simulator and timed task performance in a cadaveric shoulder arthroscopy model.

METHODS: Subjects were recruited from among residents and attending surgeons in an orthopaedic surgery residency program. Each subject was tested on an arthroscopic shoulder simulator and objectively scored on the basis of the time taken to complete a standardized object selection program. After an interval of at least two weeks, each subject was then tested on a cadaveric shoulder arthroscopy model designed to replicate the shoulder arthroscopy simulator testing protocol, and the time to completion was again recorded. Both testing protocols involved the simple task of placing a probe on a series of assigned locations in the glenohumeral joint. Spearman rank correlation analysis was performed, and regression analysis was used to determine the predictive ability of the simulator score.

RESULTS: The performance time on the simulation program was strongly correlated with the performance time on the cadaveric model (r = 0.736, p < 0.001). The time required to complete the simulator task was a significant predictor of the time required to complete the cadaveric task (t = 4.48, p < 0.001).

CONCLUSIONS: These results demonstrated a strong correlation between performance of basic arthroscopic tasks in a simulator model and performance of the same tasks in a cadaveric model.

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ARTHRO Mentor Validation Studies Abstracts

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