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A prospective assessment of the learning curves of Residents and Medical Students using a knee arthroscopy simulator simulator
ESSKA Academy. Liebensteiner M. May 9, 2018; 212162; P02-171 Topic: Arthroscopic Surgery
Michael Liebensteiner
Michael Liebensteiner
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Abstract
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Objectives: Arthroscopic interventions can be considered as standard procedures for many indications in orthopaedic surgery. Especially injuries of the knee (e.g. meniscal tear, cruciate ligament rupture) and the shoulder (e.g. rotator cuff tear, lesions of the glenoid labrum) are diagnosed and treated by arthroscopy. The technical skills to perform an arthroscopy are multifaceted as well as an arthroscopy requires different skills than a traditional open surgery approach. Arthroscopic training simulators aim to assist orthopedic residents in acquiring and improving skills for performing arthroscopic surgeries. The aim of the study was to evaluate the learning curves of medical students and orthopaedic residents using a athroscopy simulator on different treatments of shoulder and knee joint diseases.

Methods: The learning curves of two groups which did different exercises of knee arthroscopy have been compared. One of the two groups was represented by medical students of Medizinische Universität Innsbruck, without any prior knowledges of arthroscopy, the other by assistant doctors who learned arthroscopy in operation courses for example. Also the members of this group did their first training on the arthroscopy simulator. Different parameters have been analysed, like the time needed to do an exercise, or parameters which indicate the damages to the surrounding tissues.

Results: Residents improved their arthroscopic skills by reducing the simulation time from 7 minutes to 2 min on average, while students reduced their simulation time spent for each exercise from 7.5 minutes to 2 minutes. After exercising students were able to perform 75% less movements with the left hand and 55% less movements with the right hand, while residents could do the same using 87.5% less movements of the left hand and 85% less movements for the right hand.

Conclusions: The analysis of the data showed significant positive effects of the simulator training. The participants were able to reduce the time they needed to do an exercise. There was also a decrease of possible damages to the virtual surrounding tissues. In general, the assistant doctors had better mean values, but the students had the steeper learning curve. So it seems that particularly less experienced surgeons can benefit a lot from the training on the simulator. It can be expected, that in the next years simulators will become an important training tool in addition to cadaveric training and participating in arthroscopic operations.

Keywords:
Education; Orthopaedic surgery; Knee arthroscopy; Simulation, Learning curve; Training.
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