title: Arthroscopy skills development with a surgical simulator: a comparative study in orthopaedic surgery residents.
abstract: BACKGROUND
  Surgical simulation has become increasingly relevant to orthopaedic surgery education and could translate to improved operating room proficiency in orthopaedic surgery trainees.
  
  
  OBJECTIVE
  To compare the arthroscopic performance of junior orthopaedic surgery residents who received training with a knee and shoulder arthroscopy surgical simulator with those who received didactic training.
  
  
  METHODS
  Controlled laboratory study.
  
  
  METHODS
  Fourteen junior orthopaedic surgery residents at a single institution were randomized to receive knee and shoulder arthroscopy training with a surgical simulator (n = 8) or didactic lectures with arthroscopy models (n = 6). After their respective training, performance in diagnostic knee and shoulder arthroscopy was assessed using a cadaveric model. Time to completion and assessment of arthroscopic handling using a subjective injury grading index (scale, 1-10) was then used to evaluate performance in final cadaveric testing.
  
  
  RESULTS
  Orthopaedic surgery residents who trained with a surgical simulator outperformed the didactic-trained residents in shoulder arthroscopy by time to completion (-35%; P = .02) and injury grading index (-35%; P = .01). In addition, a trend toward improved performance of knee arthroscopy by the simulator-trained group was found by time to completion (-36%; P = .09) and injury grading index (P = .08).
  
  
  CONCLUSIONS
  In this study, junior orthopaedic surgery residents who trained with a surgical simulator demonstrated improved arthroscopic performance in both knee and shoulder arthroscopy. However, future validation of surgical simulator training for orthopaedic surgery residents remains warranted.
  
  
  CONCLUSIONS
  Surgical skill development with an arthroscopy surgical simulator could translate to improved arthroscopy performance in the operating room.
authors.affiliation: Department of Orthopaedics, Hospital for Special Surgery, New York, New York, USA rebolledob@hss.edu.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Rebolledo
authors.affiliation: Bioskills Education Laboratory, Hospital for Special Surgery, New York, New York, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hammann-Scala
authors.affiliation: Department of Orthopaedics, Hospital for Special Surgery, New York, New York, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Leali
authors.affiliation: Department of Orthopaedics, Hospital for Special Surgery, New York, New York, USA.
authors.forename: Anil S
authors.initials: AS
authors.lastname: Ranawat
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000193:education* / Q000295:instrumentation; D002102:Cadaver; D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008953:Models, Anatomic; D019637:Orthopedic Procedures / Q000193:education; D009985:Orthopedics / Q000193:education*; D011446:Prospective Studies; D012785:Shoulder Joint / Q000601:surgery; D013663:Teaching / Q000379:methods; D013664:Teaching Materials
keywords: arthroscopy simulator; surgical education; surgical simulator; virtual reality