Aksoy Mehmet Emin, Kocaoglu Baris, İzzetoglu Kurtulus, Agrali Atahan, Yoner Serhat Ilgaz, Polat Mert Deniz, Kayaalp Mahmut Enes, Yozgatli Tahir Koray, Kaya Alper, Becker Roland
Department of Biomedical Device Technology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
CASE (Center of Advanced Simulation and Education), Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2023 Dec;31(12):5332-5345. doi: 10.1007/s00167-023-07571-0. Epub 2023 Sep 24.
Virtual arthroscopic training has become increasingly popular. However, there is a lack of efficiency-based tracking of the trainee, which may be critical for determining the specifics of training programs and adapting them for the needs of each trainee. This study aims to evaluate and compare the measures obtained with a non-invasive neurophysiological method with The Diagnostic Arthroscopy Skill Score (DASS), a commonly used assessment tool for evaluating arthroscopic skills.
The study collected simulator performance scores, consisting of "Triangulation Right Hand", "Triangulation Left Hand", "Catch the Stars" and "Three Rings" and DASS scores from 22 participants (11 novices, 11 experts). These scores were obtained while participants underwent a structured program of exercises for the fundamentals of arthroscopic surgery training (FAST) and knee module using a simulator-based arthroscopy device. During the evaluation, data on oxy-hemoglobin and deoxy-hemoglobin levels in the prefrontal cortex were collected using the Functional Near-Infrared Spectroscopy (fNIRS) imaging system. Performance scores, DASS scores, and fNIRS data were subsequently analyzed to determine any correlation between performance and cortex activity.
The simulator performance scores and the DASS scores were significantly higher in the expert group compared to the novice group (200.1 ± 28.5 vs 172.5 ± 48.9, p = 0.04 and 9.4 ± 5.6 vs. 5.4 ± 5.6 p = 0.02). In the expert group, fNIRS data showed a significantly lower prefrontal cortex activation during fundamental tasks in the FAST module, indicating significantly more efficient mental resource use.
The analysis of cognitive workload changes during simulation-based arthroscopy training revealed a significant correlation between the trainees' DASS scores and fNIRS data. This correlation suggests the potential use of fNIRS data and DASS scores as additional metrics to create adaptive training protocols for each participant. By incorporating these metrics, the training process can be optimized, leading to more efficient arthroscopic training and better preparedness for clinical operations.
III.
虚拟关节镜训练越来越受欢迎。然而，缺乏基于效率的对受训者的跟踪，这对于确定训练计划的具体细节并使其适应每个受训者的需求可能至关重要。本研究旨在评估和比较通过非侵入性神经生理学方法获得的测量结果与诊断关节镜技能评分（DASS），DASS是一种常用的评估关节镜技能的工具。
该研究收集了22名参与者（11名新手，11名专家）的模拟器性能评分，包括“右手三角定位”“左手三角定位”“抓星星”和“三环”，以及DASS评分。这些评分是在参与者使用基于模拟器的关节镜设备进行关节镜手术基础训练（FAST）和膝关节模块的结构化练习程序时获得的。在评估过程中，使用功能近红外光谱（fNIRS）成像系统收集前额叶皮质中氧合血红蛋白和脱氧血红蛋白水平的数据。随后分析性能评分、DASS评分和fNIRS数据，以确定性能与皮质活动之间的任何相关性。
与新手组相比，专家组的模拟器性能评分和DASS评分显著更高（200.1±28.5对172.5±48.9，p = 0.04；9.4±5.6对5.4±5.6，p = 0.02）。在专家组中，fNIRS数据显示在FAST模块的基础任务期间前额叶皮质激活显著降低，表明精神资源使用效率显著更高。
基于模拟的关节镜训练期间认知工作量变化的分析揭示了受训者的DASS评分与fNIRS数据之间存在显著相关性。这种相关性表明fNIRS数据和DASS评分有可能作为额外的指标，为每个参与者创建适应性训练方案。通过纳入这些指标，可以优化训练过程，从而实现更高效的关节镜训练并更好地为临床手术做好准备。
III级
