Service d'orthopédie, centre chirurgical Emile-Gallé, CHRU de Nancy, 49, rue Hermite, 54000 Nancy, France.
Service d'orthopédie, CHRU de Rennes, 35000 Rennes, France.
Orthop Traumatol Surg Res. 2020 Jun;106(4):717-724. doi: 10.1016/j.otsr.2020.03.009. Epub 2020 Apr 10.
Arthroscopy training using a virtual reality (VR) simulator is said to improve the training of orthopedic surgery residents, although it has never been evaluated in a large representative population of first-year residents.
We hypothesized that first-year residents who train on a VR simulator would improve their basic arthroscopy skills more than residents who use other training methods. The primary aim was to compare various arthroscopy-learning techniques after 6 months of training.
The study population consisted of 107 first-year residents who were tested twice on a VR arthroscopy simulator (December 2017 and June 2018). The residents were divided into three groups: no specific arthroscopy training (A), non-specific and one-off arthroscopy training (B), 6 months of VR arthroscopy simulator training (C). During the testing, they had to perform the Periscoping exercise (orientation of angled scope) and the Catch the Stars Glenohumeral exercise (extraction of loose bodies). The parameters analyzed were time (s), camera alignment relative to horizontal (%), camera path length (cm) and grasper path length (cm).
After 6 months, there was a significant difference between groups during the Periscoping exercise in the time (A: 137.8 s; B: 126.7 s; C: 92.2 s) (p<0.0001), camera alignment (A: 93%; B: 98%; C: 97%) (p=0.0028), camera path length (A: 116.9cm; B: 112.5cm; C: 67.3cm) (p<0.0001) and during the Catch the Stars Glenohumeral exercise in the time (A: 112.2 s; B: 103 s; C: 61.4 s) (p<0.0001), camera path length (A: 46.3cm; B: 40.9cm; C: 32.9cm) (p<0.0153) and grasper path length (A: 146.4cm; B: 142.2cm; C: 95.8cm) (p<0.0001).
The residents who participated in the VR arthroscopy simulator training program for 6 months had better results when performing practical exercises and standard arthroscopy tasks than those who did not receive any training or only received only one-off training. Their final performance indicated technical mastery that the other residents had not achieved.
II, Prospective, comparative, non-randomized study.
使用虚拟现实（VR）模拟器进行关节镜培训据称可以提高骨科住院医师的培训水平，尽管它从未在大量第一年住院医师的代表性人群中进行过评估。
我们假设在 VR 模拟器上接受培训的第一年住院医师在基本关节镜技能方面的提高将超过使用其他培训方法的住院医师。主要目的是在 6 个月的培训后比较各种关节镜学习技术。
研究人群包括 107 名第一年住院医师，他们在 VR 关节镜模拟器上接受了两次测试（2017 年 12 月和 2018 年 6 月）。住院医师分为三组：无特定关节镜训练（A）、非特定和一次性关节镜训练（B）、6 个月 VR 关节镜模拟器训练（C）。在测试过程中，他们必须进行 Periscoping 练习（倾斜镜的定向）和 Catch the Stars Glenohumeral 练习（提取游离体）。分析的参数包括时间（s）、相对于水平的相机对准度（%）、相机路径长度（cm）和抓握器路径长度（cm）。
6 个月后，在 Periscoping 练习中，各组之间的时间（A：137.8 s；B：126.7 s；C：92.2 s）（p<0.0001）、相机对准度（A：93%；B：98%；C：97%）（p=0.0028）、相机路径长度（A：116.9cm；B：112.5cm；C：67.3cm）（p<0.0001）存在显著差异。在 Catch the Stars Glenohumeral 练习中，时间（A：112.2 s；B：103 s；C：61.4 s）（p<0.0001）、相机路径长度（A：46.3cm；B：40.9cm；C：32.9cm）（p<0.0153）和抓握器路径长度（A：146.4cm；B：142.2cm；C：95.8cm）（p<0.0001）也存在显著差异。
与未接受任何培训或仅接受一次性培训的住院医师相比，参加 6 个月 VR 关节镜模拟器培训计划的住院医师在进行实际练习和标准关节镜任务时的表现更好。他们的最终表现表明他们已经掌握了其他住院医师尚未达到的技术水平。
II，前瞻性、比较、非随机研究。
