Introduction Surgical training is undergoing major changes with significant reductions in time to train and an increasing focus on patient safety. Low fidelity, low-cost laparoscopic simulators have been shown to be an effective training tool and acceptable to trainees however there is no comparable evidence within the orthopaedic context. The Arthrobox is a multi-portal collapsible box that includes several interchangeable skills modules. The aim of this study was to assess whether a low cost portable simulator that trainees can take home is a useful method of improving basic arthroscopic skills.
Methods 20 novices (medical students) underwent a 1 day training course on the Arthrobox and completed a stacking elastic band onto a 4-peg grid task. 6 portal configurations in order of increasing difficulty were assessed using time taken (seconds) and the Arthroscopic Surgical Skills Evaluation Tool (ASSET) global rating scale by two expert arthroscopic surgeons. Participants were then randomised into two groups. The control group(n = 10) received no further training whereas the test group(n = 10) were able to take the Arthrobox simulator home for free practice for 1 month. All participants returned to complete the same tasks and were assessed by the same experts.
Results All 20 participants completed the study. The test group demonstrated a statistically significant improvement in time to complete the task in all 6 portal configurations (P < 0.05) whereas the control group did not demonstrate any improvement(P = 0.86). Mean ASSET scores showed statistically significant global improvement in the test group across all domains compared to the control group (P < 0.05).
Conclusion This study demonstrates that a low-cost, portable simulator that can be taken home is a valid method of acquisition of arthroscopic surgical skills. Although lacking in face validity and realism the Arthrobox can complement other high fidelity simulators and has a role in delivering affordable, available and effective skills training.
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