title: Evaluation of a virtual-reality-based simulator using passive haptic feedback for knee arthroscopy.
abstract: OBJECTIVE
  The aim of this work is to determine face validity and construct validity of a new virtual-reality-based simulator for diagnostic and therapeutic knee arthroscopy.
  
  
  METHODS
  The study tests a novel arthroscopic simulator based on passive haptics. Sixty-eight participants were grouped into novices, intermediates, and experts. All participants completed two exercises. In order to establish face validity, all participants filled out a questionnaire concerning different aspects of simulator realism, training capacity, and different statements using a seven-point Likert scale (range 1-7). Construct validity was tested by comparing various simulator metric values between novices and experts.
  
  
  RESULTS
  Face validity could be established: overall realism was rated with a mean value of 5.5 points. Global training capacity scored a mean value of 5.9. Participants considered the simulator as useful for procedural training of diagnostic and therapeutic arthroscopy. In the foreign body removal exercise, experts were overall significantly faster in the whole procedure (6 min 24 s vs. 8 min 24 s, p < 0.001), took less time to complete the diagnostic tour (2 min 49 s vs. 3 min 32 s, p = 0.027), and had a shorter camera path length (186 vs. 246 cm, p = 0.006).
  
  
  CONCLUSIONS
  The simulator achieved high scores in terms of realism. It was regarded as a useful training tool, which is also capable of differentiating between varying levels of arthroscopic experience. Nevertheless, further improvements of the simulator especially in the field of therapeutic arthroscopy are desirable. In general, the findings support that virtual-reality-based simulation using passive haptics has the potential to complement conventional training of knee arthroscopy skills.
  
  
  METHODS
  II.
authors: Orthopaedic Department, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
authors: Sandro F
authors: SF
authors: Fucentese
authors: Stefan
authors: S
authors: Rahm
authors: Karl
authors: K
authors: Wieser
authors: Jonas
authors: J
authors: Spillmann
authors: Matthias
authors: M
authors: Harders
authors: Peter P
authors: PP
authors: Koch
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000379:methods*; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D014584:User-Computer Interface