Orthopedic Research Center Amsterdam, Department of Orthopedic Surgery, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2010 Feb;18(2):218-24. doi: 10.1007/s00167-009-0872-3. Epub 2009 Jul 24.
The demand for high quality care is in contrast to reduced training time for residents to develop arthroscopic skills. Thereto, simulators are introduced to train skills away from the operating room. In our clinic, a physical simulation environment to Practice Arthroscopic Surgical Skills for Perfect Operative Real-life Treatment (PASSPORT) is being developed. The PASSPORT concept consists of maintaining the normal arthroscopic equipment, replacing the human knee joint by a phantom, and integrating registration devices to provide performance feedback. The first prototype of the knee phantom allows inspection, treatment of menisci, irrigation, and limb stressing. PASSPORT was evaluated for face and construct validity. Construct validity was assessed by measuring the performance of two groups with different levels of arthroscopic experience (20 surgeons and 8 residents). Participants performed a navigation task five times on PASSPORT. Task times were recorded. Face validity was assessed by completion of a short questionnaire on the participants' impressions and comments for improvements. Construct validity was demonstrated as the surgeons (median task time 19.7 s [8.0-37.6]) were more efficient than the residents (55.2 s [27.9-96.6]) in task completion for each repetition (Mann-Whitney U test, P < 0.05). The prototype of the knee phantom sufficiently imitated limb outer appearance (79%), portal resistance (82%), and arthroscopic view (81%). Improvements are required for the stressing device and the material of cruciate ligaments. Our physical simulation environment (PASSPORT) demonstrates its potential to evolve as a training modality. In future, automated performance feedback is aimed for.
对高质量护理的需求与住院医师培养关节镜技能的时间减少形成对比。因此，引入模拟器来在手术室之外进行技能培训。在我们的诊所中，正在开发一种用于练习关节镜手术技能以实现完美手术真实治疗的物理模拟环境（PASSPORT）。PASSPORT 概念包括保持正常的关节镜设备，用人造膝关节代替人体膝关节，并集成注册设备以提供性能反馈。膝关节模型的第一个原型允许检查、半月板治疗、冲洗和肢体施压。评估了 PASSPORT 的表面效度和结构效度。结构效度通过测量具有不同关节镜经验水平的两组（20 名外科医生和 8 名住院医师）的表现来评估。参与者在 PASSPORT 上进行了五次导航任务，记录了任务时间。通过参与者对印象和改进意见的简短问卷评估表面效度。结构效度表现为外科医生（中位任务时间 19.7 秒[8.0-37.6]）在每次重复的任务完成中比住院医师（55.2 秒[27.9-96.6]）更有效（Mann-Whitney U 检验，P<0.05）。膝关节模型充分模拟了肢体外观（79%）、端口阻力（82%）和关节镜视图（81%）。需要改进施压装置和十字韧带的材料。我们的物理模拟环境（PASSPORT）展示了作为一种培训方式发展的潜力。未来的目标是实现自动性能反馈。
