Construct Validity for a Cost-effective Arthroscopic Surgery Simulator for Resident Education.
BACKGROUND
Arthroscopy is one of the most challenging surgical skills to assess and teach. Although basic psychomotor arthroscopic skills, such as triangulation and object manipulation, are incorporated into many simulation exercises, they are not always individually taught or objectively evaluated. In addition, arthroscopic instruments, arthroscopy cameras, and the cadaver or joint models necessary for practice are costly.


METHODS
A low-cost arthroscopic simulator was created to practice triangulation, probing, horizon changes, suture management, and object manipulation. The simulator materials were purchased exclusively from national hardware stores with a total cost averaging $79. The universal serial bus (USB) camera is included in the total cost. Three residency programs accredited by the Accreditation Council for Graduate Medical Education were tested on the simulator. Replica boards were created at each institution. Participants included medical students (20), residents (46), and attending physicians (9).


RESULTS
Construct validity-the ability to differentiate between novice, intermediate, and senior level participants-was obtained. On all tasks, junior residents scored at a statistically significant lower rate than senior residents and attending physicians.


CONCLUSIONS
This cost-effective arthroscopic surgical simulator objectively demonstrated that attending physicians and senior residents performed at a higher level than junior residents and novice medical students. The results of this study demonstrate that this simulator could be an important training tool for resident education.
From Rush University, Chicago, IL (Dr. Lopez), Wake Forest University School of Medicine, Winston-Salem, NC (Dr. Martin and Dr. Bracey), the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO (Dr. Wright), and the Department of Orthopaedics, University of California Irvine, Irvine, CA (Dr. Jung, Dr. Hahn, Dr. Jain, and Dr. Gupta).
Gregory
G
Lopez
David F
DF
Martin
Rick
R
Wright
James
J
Jung
Peter
P
Hahn
Nickul
N
Jain
Daniel N
DN
Bracey
Ranjan
R
Gupta
D001182:Arthroscopy / Q000191:economics / Q000295:instrumentation*; D002983:Clinical Competence; D018961:Educational Technology / Q000191:economics*; D006801:Humans; D007396:Internship and Residency / Q000191:economics* / Q000379:methods; D000066908:Simulation Training / Q000191:economics*; D014481:United States