title: Validation of a virtual reality-based simulator for shoulder arthroscopy.
abstract: OBJECTIVE
  This study was to determine face and construct validity of a new virtual reality-based shoulder arthroscopy simulator which uses passive haptic feedback.
  
  
  METHODS
  Fifty-one participants including 25 novices (<20 shoulder arthroscopies) and 26 experts (>100 shoulder arthroscopies) completed two tests: for assessment of face validity, a questionnaire was filled out concerning quality of simulated reality and training potential using a 7-point Likert scale (range 1-7). Construct validity was tested by comparing simulator metrics (operation time in seconds, camera and grasper pathway in centimetre and grasper openings) between novices and experts test results.
  
  
  RESULTS
  Overall simulated reality was rated high with a median value of 5.5 (range 2.8-7) points. Training capacity scored a median value of 5.8 (range 3-7) points. Experts were significantly faster in the diagnostic test with a median of 91 (range 37-208) s than novices with 1177 (range 81-383) s (p < 0.0001) and in the therapeutic test 102 (range 58-283) s versus 229 (range 114-399) s (p < 0.0001). Similar results were seen in the other metric values except in the camera pathway in the therapeutic test.
  
  
  CONCLUSIONS
  The tested simulator achieved high scores in terms of realism and training capability. It reliably discriminated between novices and experts. Further improvements of the simulator, especially in the field of therapeutic arthroscopy, might improve its value as training and assessment tool for shoulder arthroscopy skills.
  
  
  METHODS
  II.
authors: Orthopaedic Department, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland. stefan_rahm@yahoo.com.
authors: Stefan
authors: S
authors: Rahm
authors: Orthopaedic Department, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
authors: Marco
authors: M
authors: Germann
authors: Orthopaedic Department, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
authors: Andreas
authors: A
authors: Hingsammer
authors: Orthopaedic Department, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
authors: Karl
authors: K
authors: Wieser
authors: Orthopaedic Department, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland.
authors: Christian
authors: C
authors: Gerber
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000193:education*; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012785:Shoulder Joint / Q000601:surgery*; D014584:User-Computer Interface
keywords: Education; Orthopaedic surgery; Passive haptics; Shoulder arthroscopy; Simulation; Virtual reality