Martin Kevin D, Patterson David P, Cameron Kenneth L
Evans Army Community Hospital, Fort Carson, Colorado, U.S.A..
DMC Sports Medicine, Detroit Medical Center, Detroit, Michigan, U.S.A.
Arthroscopy. 2016 Nov;32(11):2228-2232. doi: 10.1016/j.arthro.2016.03.026. Epub 2016 May 25.
To evaluate the correlation between timed task performance on an arthroscopy shoulder simulator and participation in a standardized expert shoulder arthroscopy educational course.
Orthopaedic trainees were voluntarily recruited from over 25 residency programs throughout the United States and Canada. Each trainee was tested on arrival at the Arthroscopy Association of North America orthopaedic learning center on a virtual reality arthroscopy shoulder simulator, and his or her performance was objectively scored. Each trainee's postgraduate year level was recorded, as was his or her experience in residency with shoulder arthroscopy as measured by Accreditation Council for Graduate Medical Education case-log totals. After the focused 4-day training curriculum consisting of didactics and cadaveric experience, each trainee was re-evaluated on the same simulator. Statistical analysis was performed to determine if participation in the course was associated with changes in simulation performance from before to after assessment.
Forty-eight trainees completed the testing. On completion of the course, trainees showed significant improvements in all objective measures recorded by the simulator. Total probe distance needed to complete the task decreased by 42% (from 420.4 mm to 245.3 mm, P < .001), arthroscope tip distance traveled decreased by 59% (from 194.1 mm to 80.2 mm, P < .001), and time to completion decreased by 38% (from 66.8 seconds to 41.6 seconds, P < .001). Highly significant improvements in all 3 measures suggest improved instrument handling, anatomic recognition, and arthroscopy-related visual-spatial ability.
This study shows objective improvement in orthopaedic trainee basic arthroscopy skill and proficiency after a standardized 4-day arthroscopy training curriculum. The results validate the Arthroscopy Association of North America resident training course and its curriculum with objective evidence of benefit.
Level III, prospective study of nonconsecutive participants.
评估在肩关节镜模拟器上进行定时任务的表现与参加标准化专家肩关节镜教育课程之间的相关性。
从美国和加拿大的25个以上住院医师培训项目中自愿招募骨科住院医师。每位住院医师抵达北美关节镜协会骨科学习中心时，都要在虚拟现实肩关节镜模拟器上接受测试，并对其表现进行客观评分。记录每位住院医师的研究生年级水平，以及根据毕业后医学教育认证委员会的病例记录总数衡量的其在肩关节镜住院医师培训中的经验。在完成为期4天的集中培训课程（包括理论教学和尸体解剖经验）后，每位住院医师在同一模拟器上重新接受评估。进行统计分析以确定参加该课程是否与评估前后模拟表现的变化相关。
48名住院医师完成了测试。课程结束时，住院医师在模拟器记录的所有客观指标上均有显著改善。完成任务所需的总探头移动距离减少了42%（从420.4毫米降至245.3毫米，P <.001），关节镜尖端移动距离减少了59%（从194.1毫米降至80.2毫米，P <.001），完成时间减少了38%（从66.8秒降至41.6秒，P <.001）。所有这三项指标的高度显著改善表明器械操作、解剖识别和与关节镜相关的视觉空间能力有所提高。
本研究表明，经过标准化的为期4天的关节镜培训课程后，骨科住院医师的基本关节镜技能和熟练程度有了客观的提高。结果以客观的受益证据验证了北美关节镜协会住院医师培训课程及其课程设置。
III级，对非连续参与者的前瞻性研究。
