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0198 Self-assessment Of Skills On A Virtual-reality Orthopaedic Trauma Simulator - Does Practice Lead To Insight Of Performance?
  1. Chetan Khatri,
  2. Kapil Sugand,
  3. Sharika Anjum,
  4. Kash Akhtar,
  5. Chinmay Gupte
  1. MSk Lab, Imperial College, London, UK


Introduction The role of self-assessment has been questioned in relation to the inaccuracy of overestimating ability within surgical disciplines. With the emergence of virtual-reality (VR) simulation as an effective method of acquiring technical surgical skills, the ability of surgical trainees to independently use this technology without the need of supervision is of great interest to international training programmes.

Objectives To observe whether medical students can accurately self-assess their performance while learning a new technical skill using a haptic-enabled VR dynamic hip screw (DHS) simulator.

Methods 28 medical students (naïve to DHS procedures and VR simulation) were recruited to perform 5 attempts after being shown an instructional video. After a week, they were asked to repeat another 5 attempts. At the end of each attempt they were asked to estimate their performance on five clinically pertinent metrics which were recorded in real-time by the VR DHS simulator after every attempt. Mean scores (with standard deviation) were calculated and Mann-Whitney U tests were used to calculate significance (p < 0.05).

Results On first attempt, participants inaccurately self-assessed significantly with respect to i) time taken by 15.3% (p = 0.006), ii) number of radiographs by 71.5% (p < .001), iii) attempts by 29.1% (p = 0.005), iv) tip-apex distance (TAD) by 227% (p < 0.001), and v) global score by 71.7% (p < 0.001). After the last attempt, participants improved accuracy in self-assessment with insignificant differences in predicted and actual results for i) time taken by 5.7% (p = 0.42) and ii) number of radiographs by 6.3% (p = 0.119). However, participants were significantly inaccurate in assessing iii) attempts by 5.2% (p = 0.0004), iv) TAD by 126% (p < 0.0001) and v) global score by 16.7% (p = 0.0001).

Conclusions Our findings agree with existing literature that trainees are unable to accurately self-assess and most concerning, overestimate their performance. However, there is evidence that trainees develop better insight with practice of the same task.


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  3. Lynch J, Aughwane P, Hammond TM. Video games and surgical ability: a literature review. Journal of Surgical Education 2010;67(3):184–189

  • Category: Course or curriculum evaluation/innovation/integration

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