Braman Jonathan P, Sweet Robert M, Hananel David M, Ludewig Paula M, Van Heest Ann E
Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A..
Department of Urologic Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A.
Arthroscopy. 2015 Jan;31(1):104-12. doi: 10.1016/j.arthro.2014.07.012. Epub 2014 Sep 18.
The purpose of our study was to develop a low-fidelity surgical simulator for basic arthroscopic skills training, with the goal of creating a pretrained novice ready with the basic skills necessary for all joint arthroscopic procedures.
A panel of education, arthroscopy, and simulation experts designed and evaluated a basic arthroscopic skills training and testing box. Task deconstruction was used to create 2 modules, which incorporate core skills common to all arthroscopic procedures. Core metrics measured were time to completion, number of trials to steady state, and number of errors. Face validity was evaluated using a questionnaire. Construct validity was examined by comparing 8 medical students with 8 expert orthopaedic surgeons.
Surgeons were faster than students on both module 1 (P = .0013), simulating triangulation skills, and module 2 (P = .0190) simulating object manipulation skills. Surgeons demonstrated fewer errors (6.9 errors versus 28.1; P = .0073). All surgeons were able to demonstrate steady state (i.e., perform 2 trials that were within 10% of each other for time to completion and errors) on both modules within 3 trials on each module. Only 2 novices were able to demonstrate steady state on either module, and both did so within 3 trials. Furthermore, face validity of the skills trainer was shown by the expert arthroscopists.
We describe a basic arthroscopy skills simulator that has face and construct validity. Our expert panel was able to design a simulator that differentiated between experienced arthroscopists and novices.
Surgical simulation is an important part of efficient surgical education. This simulator shows good construct and face validity and provides a low-fidelity option for teaching the entry-level arthroscopist.
我们研究的目的是开发一种用于基础关节镜技能训练的低保真手术模拟器，目标是培养出具备所有关节镜手术所需基本技能的预训练新手。
一个由教育、关节镜和模拟领域专家组成的小组设计并评估了一个基础关节镜技能训练和测试箱。采用任务解构法创建了2个模块，其中包含所有关节镜手术共有的核心技能。所测量的核心指标包括完成时间、达到稳定状态的试验次数和错误次数。通过问卷调查评估表面效度。通过比较8名医科学生和8名骨科专家外科医生来检验结构效度。
在模拟三角测量技能的模块1（P = 0.0013）和模拟物体操作技能的模块2（P = 0.0190）中，外科医生都比学生完成得更快。外科医生的错误更少（6.9次错误对28.1次；P = 0.0073）。所有外科医生在每个模块的3次试验内都能在两个模块上展示稳定状态（即完成时间和错误次数在彼此的10%以内进行2次试验）。只有2名新手能够在任何一个模块上展示稳定状态，且都是在3次试验内做到的。此外，关节镜专家证明了该技能训练器的表面效度。
我们描述了一种具有表面效度和结构效度的基础关节镜技能模拟器。我们的专家小组能够设计出一种能区分经验丰富的关节镜医生和新手的模拟器。
手术模拟是高效外科教育的重要组成部分。这种模拟器具有良好的结构效度和表面效度，为初级关节镜医生的教学提供了一种低保真选项。
