Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A..
Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Rush Medical College of Rush University, Chicago, Illinois, U.S.A.
Arthroscopy. 2014 Jan;30(1):121-33. doi: 10.1016/j.arthro.2013.09.084. Epub 2013 Nov 28.
The purpose of this study was to review the published literature on modern arthroscopic simulator training models to (1) determine the ability to transfer skills learned on the model to the operating room and (2) determine the learning curve required to translate such skills.
A systematic review of all studies using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed. Two independent reviewers then analyzed studies deemed appropriate for inclusion. Study data collected included participant demographic characteristics, simulator model, type and number of tasks, method of analysis, and results of training, when available. Given the different methods used in each study, descriptive analysis was performed.
Nineteen studies met the inclusion criteria (9 shoulder, 9 knee, and 1 hip). A total of 465 participants with a mean age of 30 years were evaluated. Twelve studies (63%) compared task performance among participants of different experience levels, with 100% reporting a positive correlation between experience level and simulator performance. Eight studies (42%) evaluated task performance before and after simulator training, with 6 studies showing improvement after training; 1 study noted no difference in performance after 1 hour of training. One study commented on improved operating room performance after simulator training. No studies commented on the number of training sessions needed to translate skills learned on the models to the operating room.
This review suggests that practice on arthroscopic simulators improves performance on arthroscopic simulators. We cannot, however, definitively comment on whether simulator training correlates to an improved skill set in the operating room. Further work is needed to determine the type and number of training sessions needed to translate arthroscopic skills learned on the models to the operating room.
Level IV, systematic review of studies with Level I through IV evidence.
本研究旨在回顾现代关节镜模拟器训练模型的已发表文献，以（1）确定在模型上习得的技能在手术室中的转移能力，以及（2）确定将此类技能转化所需的学习曲线。
按照 PRISMA（系统评价和荟萃分析的首选报告项目）指南对所有使用研究进行系统审查。然后，两名独立的审查员分析了被认为适合纳入的研究。收集的研究数据包括参与者的人口统计学特征、模拟器模型、任务类型和数量、分析方法以及培训结果（如果有）。鉴于每个研究中使用的方法不同，进行了描述性分析。
19 项研究符合纳入标准（9 项肩部、9 项膝关节和 1 项髋关节）。共评估了 465 名平均年龄为 30 岁的参与者。12 项研究（63%）比较了不同经验水平参与者的任务表现，100%的研究报告经验水平与模拟器表现之间存在正相关。8 项研究（42%）评估了模拟器培训前后的任务表现，其中 6 项研究显示培训后有改善；1 项研究在培训 1 小时后注意到表现没有差异。一项研究评论了模拟器培训后手术室表现的改善。没有研究评论将在模型上习得的技能转移到手术室所需的培训课程数量。
本综述表明，关节镜模拟器上的练习可提高关节镜模拟器上的表现。然而，我们不能确定模拟器培训是否与手术室中技能的提高相关。需要进一步的工作来确定将在模型上习得的关节镜技能转化到手术室所需的培训课程类型和数量。
IV 级，对具有 I 至 IV 级证据的研究进行系统评价。
