Initial validation of the arthroscopic skills acquisition tools (ASATs) : a low cost, online tool to develop and evaluate core skills for shoulder arthroscopy

Gandhi, MJ

Abstract

There are increasing time pressures on surgical training, including the European Working Time Directive. Developing arthroscopic surgical skills (keyhole surgery into a joint) has a longer learning curve than open surgery, driving the need to develop efficient training techniques. Virtual reality (VR) simulators offer great potential but such high fidelity simulators are not widespread because of their cost and subsequent access restrictions.

A structured program of developing transferrable skills using widely accessible, low cost, but low fidelity simulators may help maximise training opportunities on VR simulators. To address this, the author developed the Arthroscopic Skills Acquisition Tools (ASATs), designed to develop and evaluate the core skills for shoulder arthroscopy, to complement training on VR simulators, cadavers and real patients.

This thesis presents the initial validation study of the ASATs. Performance, assessed using a VR simulator correlates with intra-operative and cadaveric arthroscopic performance and can differentiate between novices and experts, thereby providing a practical “gold standard” test environment for the initial validation of the ASATs. This MPhil study aims to evaluate correlations between performance measured using one of the ASATs and performance on a VR shoulder arthroscopy simulator.

Following ethical approvals, 49 volunteers were recruited and individually received a 1-hour standardised introduction and familiarisation process containing written material, videos and five different ASATs. They were then assessed using a sixth ASAT and four VR tasks. Correlations were assessed between the ASAT measures and the VR measures using Pearson’s correlation coefficients.

The results showed 64 significant correlations from a possible 171, of which 19 showed a moderate or stronger relationship (r > 0.5). More significantly was the correlations pattern, which helps to identify which performance measures to target during further development work on the ASATs. However, there remains questions about the optimal timing, intensity and competence levels of such training.

• Thesis Type: Dissertation
• Deposit Date: Mar 20, 2017
• Publicly Available Date: Mar 20, 2017