Surgical simulation training in orthopedics: current insights

Figures & data

Figure 1 PRISMA diagram.

Abbreviation: PRISMA, Preferred Reporting Items for Systematic reviews and Meta-Analyses.

Table 1 Experimental study characteristics

Study	Participants	Simulator model	Experimental group	Control group	Assessment tools	Other outcomes	Principal results
Dunn et al^Citation14	Seventeen residents from different postgraduate years	ArthoVR shoulder simulator (high fidelity)	Four 15-minute one-on-one sessions on simulator with experienced arthroscopist over 3 months	Shoulder arthroscopy video, written procedural checklist, primed on simulator	ASSET GRS, 14-point anatomic checklist, ASSET safety score	Time	No statistically significant differences between experimental and control groups
Waterman et al^Citation15	Twenty-two residents from different postgraduate years	ArthoVR shoulder simulator (high fidelity)	Shoulder arthroscopy video, slideshow of anatomy and arthroscopic images, four 15-minute one-on-one sessions on simulator with senior resident over 3 months	Shoulder arthroscopy video, slideshow of anatomy and arthroscopic images	ASSET GRS, 14-point anatomic checklist, ASSET safety score	Time, camera distance, probe distance	Experimental group did significantly better on ASSET safety score, time, and probe distance, compared to control group
Cannon et al^Citation12	Forty-eight postgraduate year 3 residents	ArthroSim VR Arthroscopic Knee Simulator (high fidelity)	Knee arthroscopy video, written description of procedure, watch live clips, practice on simulator	Knee arthroscopy video, written description of procedure	Previously validated procedural checklist, GRS	Time	Experimental group did significantly better on checklist compared to control group
Howells et al^Citation13	Twenty junior residents with <2 years of experience	Arthroscopy knee bench-top simulator (low fidelity)	Three sessions of six arthroscopies per session over 1 week	Regular training program	Orthopedic competence assessment project checklist, modified OSATS GRS	Total probe path length, time, and number of hand movements	Experimental group did significantly better on checklist and GRS

Abbreviations: ASSET, Arthroscopic Surgery Skill Evaluation Tool; GRS, Global Rating Scale; OSATS, Objective Structured Assessment of Technical Skills; VR, virtual reality.

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