Article Text

SC6 Validation of a virtual reality fundamentals of arthroscopic surgery training programme
  1. Kalpesh Vaghela,
  2. J Lee,
  3. K Akhtar
  1. Royal London Hospital, UK


Introduction Arthroscopy is the most common orthopaedic procedure performed in the United Kingdom and requires mastery of a number of basic skills that are then fluidly combined to perform complex procedures. The Fundamentals of Arthroscopic Surgery Training (FAST) programme was developed to breakdown arthroscopy into its basic psychomotor tasks. Virtual Reality (VR) FAST modules have been developed to allow trainees to practice skills with immediate, unbiased metric-based feedback. The aim of this study was to determine whether a VR FAST programme is able to distinguish between individuals of differing levels of experience.

Methods Seven virtual reality FAST modules including three basic camera tasks (image centring, horizon control and telescoping), 2 advanced camera tasks (periscoping and line tracing) and 2 instrumented bimanual dexterity tasks (probe triangulation and gathering stars) formed the basis of a VR FAST programme. 60 participants including experts (orthopaedic consultants; n = 10), intermediates (orthopaedic registrars n = 30) and novices (medical students; n = 20) completed each FAST module. The metrics recorded included the time taken, camera path length and instrument path length.

Results The basic FAST camera modules did not demonstrate a statistically significant difference between experts, intermediates and novices (p=0.68). Advanced FAST camera modules demonstrated construct validity with less time taken and superior economy of movement by experts and intermediates compared to novices (P<0.05). The bimanual dexterity FAST modules demonstrated a strongly statistically significant superior performance between each of the three groups (P<0.01). Ambidexterity correlated to the level of experience with experts more proficient than intermediates and novices in the advanced FAST camera modules (P<0.05) and bimanual dexterity FAST modules (P<0.01).

Conclusion This study represents a novel method of assessing fundamental arthroscopic skills using a VR simulator platform. Participants with the most arthroscopic surgical experience performed superiorly in advanced camera handing and bimanual dexterity tasks than novices. Basic camera handling modules did not discriminate between experience levels and may require further development.

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