Palet Miguel J, Antúnez-Riveros Marcela, Barahona Maximiliano
Department of Orthopedic Surgery, Faculty of Medicine, University of Chile, Santiago, CHL.
Department of Health Sciences Education, Faculty of Medicine, University of Chile, Santiago, CHL.
Cureus. 2021 May 25;13(5):e15237. doi: 10.7759/cureus.15237.
Objective Surgical techniques are learned gradually throughout an orthopedic residency. Training on real patients carries drawbacks such as limited access and elevated risk. Alternatively, surgical simulation allows residents to practice in a safe environment with greater access to standardized surgical tasks. Virtual reality simulators display images inside an artificial joint, often providing real-time haptic feedback to allow for realistic interaction. The objective of this study was to evaluate the construct validity of a virtual reality simulator for knee arthroscopy by analyzing the capacity of system parameters to distinguish between expert and novice surgeons. Design This comparative cross-sectional study contrasts the automated performance reports for novice and expert orthopedic surgeons after executing surgical tasks on the ARTHRO Mentor virtual reality simulator. Setting Surgical simulation center at the University of Chile Clinical Hospital, Santiago, Chile. Participants The novice group consisted of 20 second-year orthopedic and traumatology residents at the University of Chile School of Medicine. The expert group consisted of 10 experienced arthroscopic surgeons. All participants carried out standardized tasks in the knee arthroscopy virtual reality simulator. The median performance scores of the two groups were compared, and multivariate logistic regression was performed to assess the capacity of the system to discriminate between the two groups. Results Median performance on the vast majority of surgical tasks was superior for the expert group. The expert group had performance values equal to or higher than the novice group on 43 of the 44 variables recorded for the basic tasks and 74 of the 75 advanced task variables. The multivariate logistic regression analysis discriminated expert from novice users with 100% accuracy. Conclusion The virtual reality simulator for knee arthroscopy showed good construct validity, with performance metrics accurately discriminating between expert and novice users.
目的 在整个骨科住院医师培训期间，手术技术是逐步习得的。在真实患者身上进行训练存在一些缺点，比如机会有限且风险增加。相比之下，手术模拟能让住院医师在安全环境中练习，更便于进行标准化的手术任务。虚拟现实模拟器在人工关节内显示图像，通常还会提供实时触觉反馈，以实现逼真的交互。本研究的目的是通过分析系统参数区分专家外科医生和新手外科医生的能力，来评估一种用于膝关节镜检查的虚拟现实模拟器的结构效度。
设计 这项比较性横断面研究对比了新手和专家骨科医生在ARTHRO Mentor虚拟现实模拟器上执行手术任务后的自动性能报告。
地点 智利圣地亚哥智利大学临床医院的手术模拟中心。
参与者 新手组由智利大学医学院20名二年级骨科与创伤学住院医师组成。专家组由10名经验丰富的关节镜外科医生组成。所有参与者都在膝关节镜检查虚拟现实模拟器中执行了标准化任务。比较了两组的中位性能得分，并进行多因素逻辑回归分析，以评估该系统区分两组的能力。
结果 在绝大多数手术任务中，专家组的中位表现更优。在记录的44个基本任务变量中的43个以及75个高级任务变量中的74个上，专家组的表现值等于或高于新手组。多因素逻辑回归分析以100%的准确率区分了专家用户和新手用户。
结论 用于膝关节镜检查的虚拟现实模拟器显示出良好的结构效度，性能指标能准确区分专家用户和新手用户。
