title: Validation of the ArthroS virtual reality simulator for arthroscopic skills.
abstract: OBJECTIVE
  Virtual reality simulator training has become important for acquiring arthroscopic skills. A new simulator for knee arthroscopy ArthroS™ has been developed. The purpose of this study was to demonstrate face and construct validity, executed according to a protocol used previously to validate arthroscopic simulators.
  
  
  METHODS
  Twenty-seven participants were divided into three groups having different levels of arthroscopic experience. Participants answered questions regarding general information and the outer appearance of the simulator for face validity. Construct validity was assessed with one standardized navigation task. Face validity, educational value and user friendliness were further determined by giving participants three exercises and by asking them to fill out the questionnaire.
  
  
  RESULTS
  Construct validity was demonstrated between experts and beginners. Median task times were not significantly different for all repetitions between novices and intermediates, and between intermediates and experts. Median face validity was 8.3 for the outer appearance, 6.5 for the intra-articular joint and 4.7 for surgical instruments. Educational value and user friendliness were perceived as nonsatisfactory, especially because of the lack of tactile feedback.
  
  
  CONCLUSIONS
  The ArthroS™ demonstrated construct validity between novices and experts, but did not demonstrate full face validity. Future improvements should be mainly focused on the development of tactile feedback. It is necessary that a newly presented simulator is validated to prove it actually contributes to proficiency of skills.
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Centre, Orthopedic Research Center Amsterdam, G4-262 Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. j.j.stunt@amc.uva.nl.
authors.forename: J J
authors.initials: JJ
authors.lastname: Stunt
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Centre, Orthopedic Research Center Amsterdam, G4-262 Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. g.m.kerkhoffs@amc.uva.nl.
authors.forename: G M M J
authors.initials: GM
authors.lastname: Kerkhoffs
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Centre, Orthopedic Research Center Amsterdam, G4-262 Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. c.n.vandijk@amc.uva.nl.
authors.forename: C N
authors.initials: CN
authors.lastname: van Dijk
authors.affiliation: Department of Orthopedic Surgery, Academic Medical Centre, Orthopedic Research Center Amsterdam, G4-262 Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. g.j.tuijthof@amc.uva.nl.|Department of Biomechanical Engineering, Faculty of Mechanical, Materials and Maritime Engineering, Delft University of Technology, Delft, The Netherlands. g.j.tuijthof@amc.uva.nl.
authors.forename: G J M
authors.initials: GJ
authors.lastname: Tuijthof
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014584:User-Computer Interface; D055815:Young Adult
keywords: Arthroscopic training; Simulator; Validation