Department of Orthopaedic Surgery, Brooke Army Medical Center, San Antonio, TX, USA.
Department of Orthopaedic Surgery, Louisiana State University Health Science Center, New Orleans, LA, USA.
Surg Innov. 2024 Feb;31(1):75-81. doi: 10.1177/15533506231211474. Epub 2023 Oct 26.
Surgical training using simulation can fill gaps in traditional surgical residency learning. We hypothesize that arthroscopy training conducted on a virtual reality simulator will be preferred by orthopaedic surgery residents over a traditional dry lab simulation model.
38 orthopaedic surgery residents at a single U.S. residency program were randomized to train for a shoulder arthroscopy procedure using either a virtual reality simulator or a table-top dry lab simulator. Training and learning preferences were then asked of the resident participants.
Junior residents were likely to report training preference for the virtual reality simulator compared to senior residents [15/24 (62.5%) v. 8/14 (57.1%); = .043]. Simulator preference was not influenced by subspecialty interest, prior arthroscopy experience, or simulator experience. Virtual reality simulation was associated with positive attitude towards arthroscopy and high chance of reporting learning gains on general arthroscopic understanding. Senior residents were 4.7 times more likely than juniors to report learning gains via staff discussion pre- and post-operatively. A majority of residents [34/38 (89.5%)] reported, however, wanting more simulation for training surgical skills.
Simulation is a desired and potentially valuable adjunct to training orthopaedic residents in arthroscopy. Training needs do evolve; and junior arthroscopists may benefit more from virtual reality platforms for general skills. Senior residents preferred dry lab simulation, possibly because it allowed for handling of actual instruments and implants.
使用模拟进行手术培训可以填补传统外科住院医师学习中的空白。我们假设,在虚拟现实模拟器上进行的关节镜培训将受到骨科住院医师的青睐,而不是传统的干式实验室模拟模型。
美国一个单一住院医师计划中的 38 名骨科住院医师被随机分配使用虚拟现实模拟器或台式干式实验室模拟器进行肩部关节镜手术的培训。然后向住院医师参与者询问培训和学习偏好。
与资深住院医师相比,初级住院医师更有可能报告对虚拟现实模拟器的培训偏好[15/24(62.5%)比 8/14(57.1%);=.043]。模拟器偏好不受专业兴趣、先前关节镜经验或模拟器经验的影响。虚拟现实模拟与对关节镜的积极态度以及对一般关节镜理解的高报告学习收益相关联。与初级住院医师相比,高级住院医师在术前和术后通过员工讨论报告学习收益的可能性高 4.7 倍。然而,大多数住院医师[34/38(89.5%)]报告说,他们希望有更多的模拟来培训手术技能。
模拟是培训骨科住院医师关节镜手术的理想且潜在有价值的辅助手段。培训需求确实在不断发展;初级关节镜医师可能从虚拟现实平台中受益于一般技能。高级住院医师更喜欢干式实验室模拟,可能是因为它允许使用实际的器械和植入物。