title: Newly acquired arthroscopic skills: Are they transferable during simulator training of other joints?
abstract: OBJECTIVE
  This randomized study investigates whether novices learning simulation-based arthroscopic skills in one anatomical joint environment can immediately transfer their learnt skills to another joint.
  
  
  METHODS
  Medical students were randomized to a simulated diagnostic knee or shoulder arthroscopic task on benchtop training models. After nine task repetitions over 3 weeks on one model, each participant undertook the simulation task of the other anatomical joint. Performance was objectively measured using a validated electromagnetic motion analysis system and a validated global rating scale (GRS).
  
  
  RESULTS
  Eighteen students participated; eight started the knee task and ten the shoulder task. All participants demonstrated a learning curve in all parameters during task repetition (time taken, hand path length, number of hand movements and GRS scores; p < 0.001) with learning effects >1 SD from initial performance (range 1.1-2.2 SD). When the groups swapped models, there was no immediate evidence of skill transfer, with a significant drop in performance between the final training episode and the transfer task (all parameters p < 0.003). In particular, the transfer task performance was no better than the first episode performance on that model by these novices.
  
  
  CONCLUSIONS
  This study showed basic arthroscopic skills did not immediately transfer to an unfamiliar anatomical environment within a simulated setting. These findings have important clinical implications with regard to surgical training as they potentially challenge the assumption that arthroscopic skills acquired in one joint are universally transferrable to other joints. Future orthopaedic simulation training should aim to deliver exposure to a greater variety of arthroscopic procedures and joint environments. This would allow trainees to become familiar with the different arthroscopic setting before undertaking real surgery and consequently improve patient safety.
  
  
  METHODS
  Therapeutic, Level II.
authors: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Windmill Lane, Headington, Oxford, OX3 7LD, UK. jamieferguson@doctors.org.uk.
authors: Jamie
authors: J
authors: Ferguson
authors: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Windmill Lane, Headington, Oxford, OX3 7LD, UK.
authors: Robert
authors: R
authors: Middleton
authors: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Windmill Lane, Headington, Oxford, OX3 7LD, UK.
authors: Abtin
authors: A
authors: Alvand
authors: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, Windmill Lane, Headington, Oxford, OX3 7LD, UK.
authors: Jonathan
authors: J
authors: Rees
mesh_terms: D001182:Arthroscopy / Q000193:education*; D002983:Clinical Competence; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D059032:Learning Curve; D009985:Orthopedics / Q000193:education; D011897:Random Allocation; D012785:Shoulder Joint / Q000601:surgery*; D000066908:Simulation Training; D013337:Students, Medical
keywords: Arthroscopy; Learning; Novice; Performance; Simulation; Skill; Training