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This Article Full Text Full Text (PDF) All Versions of this Article: 35/6/883    most recent 0363546506296521v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gomoll, A. H. Articles by Warner, J. J. P. Search for Related Content PubMed PubMed Citation Articles by Gomoll, A. H. Articles by Warner, J. J. P. Related Collections Shoulder Arthroscopy Operative

Surgical Experience Correlates With Performance on a Virtual Reality Simulator for Shoulder Arthroscopy

Andreas H. Gomoll, MD^*, Robert V. O’Toole, MD, Joseph Czarnecki, MD and Jon J. P. Warner, MD^,||

From the ^* Department of Orthopedic Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, the Division of Orthopaedic Traumatology, R. Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, Maryland, Excel Orthopaedic Specialists, Woburn, Massachusetts, and Harvard Shoulder Service, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts

^|| Address correspondence to Jon J. P. Warner, MD, Director, Harvard Shoulder Service, Professor of Orthopaedic Surgery, Harvard Medical School, Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, YAW-3, Boston, MA 02114 (e-mail: jwarner{at}partners.org).

Background: The traditional process of surgical education is being increasingly challenged by economic constraints and concerns about patient safety. Sophisticated computer-based devices have become available to simulate the surgical experience in a protected environment. As with any new educational tool, these devices have generated controversy about the validity of the training experience.

Hypothesis: Performance on a virtual reality simulator correlates with actual surgical experience.

Study Design: Controlled laboratory study.

Methods: Forty-three test subjects of various experience levels in shoulder arthroscopy were tested on an arthroscopy simulator according to a standardized protocol. Subjects were evaluated for time to completion, distance traveled with the tip of the simulated probe compared with a computer-determined optimal distance, average probe velocity, and number of probe collisions with the tissues.

Results: Subjects were grouped according to prior experience with shoulder arthroscopy. Comparing the least experienced with most experienced groups, the average time to completion decreased by 62% from 128.8 seconds to 49.2 seconds; path length and hook collisions were more than halved from 8.2 to 3.8 and 34.1 to 16.8, respectively; and average probe velocity more than doubled from 0.18 to 0.4 cm/second. There were no significant differences for any parameter tested between subjects with video game experience compared to those without.

Conclusions: The study demonstrated a close and statistically significant correlation between simulator results and surgical experience, thus confirming the hypothesis. Conversely, experience with video games was not associated with improved simulator performance. This indicates that the skill set tested may be similar to the one developed in the operating room, thus suggesting its use as a potential tool for future evaluation of surgical trainees.

Clinical Relevance: The results have implications for the future of orthopaedic surgical training programs, the majority of which have not embraced virtual reality technology for physician education.

Key Words: surgical education • shoulder arthroscopy • arthroscopy simulator

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				A. H. Gomoll, G. Pappas, B. Forsythe, and J. J. P. Warner Individual Skill Progression on a Virtual Reality Simulator for Shoulder Arthroscopy: A 3-Year Follow-up Study Am. J. Sports Med., June 1, 2008; 36(6): 1139 - 1142. [Abstract] [Full Text] [PDF]