2019 ISAKOS Biennial Congress ePoster #401
Basic Knee Simulator Model Proves to Successfully Transfer Abilities Learned to Real-Patient Scenarios
Sebastián Irarrázaval, MD, Santiago CHILE
Pablo Besa, MD, Santiago CHILE
Gerardo Ledermann, MD, Santiago CHILE
Luis A. Irribarra, MD, Santiago CHILE
Rafael Vega, MD, Santiago CHILE
Mario Orrego, MD, Prof., Santiago CHILE
Pontificia Universidad Católica de Chile, Santiago, CHILE
FDA Status Cleared
The ultimate goal for any surgical simulator is to prove capable of transferring the skills learned. We designed an arthroscopic partial meniscectomy training module and sought to determine its ability to transfer to real patients. Simulated partial meniscectomy training in orthopedic residents, proved to successfully transfer to a real clinical scenario with a high model transfer ratio.
Arthroscopic training programs based on simulation have proven capable of developing surgical skills. Most of these skills are measured on the same simulator used for training. The ultimate goal for any surgical simulator is to prove capable of transferring the skills learned to real patients. We designed an arthroscopic partial meniscectomy training module and sought to determine its ability to transfer to real patients.
Institutional review board acceptance was obtained, and all patients included gave signed written consent before inclusion. Eleven junior orthopedic residents (first and second year of training) and three expert knee surgeons were included. A knee surgical simulator (Sawbones®) was used for all simulated stages. Trainees had two base line evaluations (one on the simulator and one on a real patient) completing partial mid-body medial meniscectomies, measured using the previously validated Arthroscopic Surgical Skill Evaluation Tool (ASSET). After baseline, the trainees completed a 10-session training program and had a final evaluation of proficiency on the simulator. Finally, trainees were measure using the ASSET on a real patient partial mid-body medial meniscectomy. Experts were measured once on the simulator and once on real patients. Statistical analysis was done assuming non-parametric behavior of variables, with Wilcoxon and U Mann Whitney tests. Significance was set at 5%.
All trainees improved significantly from a median base ASSET of 10 points up to a median final ASSET of 39 points (p<0.01) on the simulator; and from a base score of 14 points up to a final score of 36 points (p<0.01) on real patients. Final trainee simulator score did not differ from experts on the simulator (p <0.01). Final trainee score on real patients was lower than final simulator score (36 vs 39 points respectively, p=0.01); which resulted in a 92% transfer ratio for the SawBones® model.
Simulated training of partial mid-body medial meniscectomy in orthopedic residents using a SawBones® knee model, proved to not only improve simulated proficiency, but also successfully transfer to a real clinical scenario with a high model transfer ratio.