title: Do the skills acquired by novice surgeons using anatomic dry models transfer effectively to the task of diagnostic knee arthroscopy performed on cadaveric specimens?
abstract: BACKGROUND
  The use of surgical simulation in orthopaedic education is increasing; however, its ideal place within the training curriculum remains unknown. The purpose of this study was to determine the effectiveness of training novice surgeons on an anatomic dry model of the knee prior to training them to perform diagnostic arthroscopy on cadaveric specimens.
  
  
  METHODS
  Fourteen medical students were randomly assigned to two groups. The experimental group was trained to perform diagnostic arthroscopy of the knee on anatomic dry models prior to training on cadaveric specimens. The control group was trained only on cadaveric specimens. Proficiency was assessed with use of a modified version of a previously validated objective assessment of arthroscopic skill, the Basic Arthroscopic Knee Skill Scoring System (BAKSSS). The mean number of trials required to attain minimal proficiency when performing diagnostic knee arthroscopy was compared between the groups. The cumulative transfer effectiveness ratio (CTER) was calculated to measure the transfer of skills acquired by the experimental group.
  
  
  RESULTS
  The mean number of trials to demonstrate minimum proficiency was significantly lower in the experimental group (2.57) than in the control group (4.57) (p &lt; 0.01). The mean time to demonstrate proficiency was also significantly less in the experimental group (37.51 minutes) than in the control group (60.48 minutes) (p &lt; 0.01). The CTER of dry-model training for the task of performing diagnostic knee arthroscopy on cadaveric specimens was 0.2.
  
  
  CONCLUSIONS
  Previous training utilizing an anatomic dry knee model resulted in improved proficiency for novice surgeons learning to perform diagnostic knee arthroscopy on cadaveric specimens. A CTER of 0.2 suggests that dry models can serve as a useful adjunct to cadaveric training for diagnostic knee arthroscopy but cannot entirely replace it within the orthopaedic curriculum. Further work is necessary to determine the optimal amount of training on anatomic dry models that will maximize transfer effectiveness and to determine how well skills obtained in the simulated environment transfer to the operating room.
authors: Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
authors: Aaron
authors: A
authors: Butler
authors: Tyson
authors: T
authors: Olson
authors: Ryan
authors: R
authors: Koehler
authors: Gregg
authors: G
authors: Nicandri
mesh_terms: D001182:Arthroscopy / Q000193:education*; D002102:Cadaver; D002983:Clinical Competence; D003479:Curriculum; D005260:Female; D006801:Humans; D007719:Knee Joint; D008297:Male; D008953:Models, Anatomic; D009985:Orthopedics / Q000193:education*; D014163:Transfer, Psychology; D014481:United States