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The internal validity of arthroscopic simulators and their effectiveness in arthroscopic education

  • Sports Medicine
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this systematic review was to identify standard procedures for the validation of arthroscopic simulators and determine whether simulators improve the surgical skills of users.

Methods

Arthroscopic simulator validation studies and randomized trials assessing the effectiveness of arthroscopic simulators in education were identified from online databases, as well as, grey literature and reference lists. Only validation studies and randomized trials were included for review. Study heterogeneity was calculated and where appropriate, study results were combined employing a random effects model.

Results

Four hundred and thirteen studies were reviewed. Thirteen studies met the inclusion criteria assessing the construct validity of simulators. A pooled analysis of internal validation studies determined that simulators could discriminate between novice and experts, but not between novice and intermediate trainees on time of completion of a simulated task. Only one study assessed the utility of a knee simulator in training arthroscopic skills directly and demonstrated that the skill level of simulator-trained residents was greater than non-simulator-trained residents.

Conclusions

Excessive heterogeneity exists in the literature to determine the internal and transfer validity of arthroscopic simulators currently available. Evidence suggests that simulators can discriminate between novice and expert users, but discrimination between novice and intermediate trainees in surgical education should be paramount. International standards for the assessment of arthroscopic simulator validity should be developed to increase the use and effectiveness of simulators in orthopedic surgery.

Level of evidence

Diagnostic study, Level III.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of California, San Francisco, CA, USA

    Jesse Alan Slade Shantz

  2. Department of Surgery, Section of Orthopedics, University of Manitoba, Winnipeg, Canada

    Jeff R. S. Leiter & Peter Benjamin MacDonald

  3. Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, Canada

    Jeff R. S. Leiter

  4. Neil John Maclean Health Sciences Library, University of Manitoba, 239 Brodie Centre, 750 McDermot Ave, Winnipeg, MB, R3T 2N2, Canada

    Tania Gottschalk

  5. Pan Am Clinic, 75 Poseidon Bay, Winnipeg, MB, R3M 3E4, Canada

    Jesse Alan Slade Shantz, Jeff R. S. Leiter & Peter Benjamin MacDonald

  6. San Francisco General Hospital, Orthopaedic Trauma Institute, 2550 23rd Street, San Francisco, CA, 94110, USA

    Jesse Alan Slade Shantz

Authors
  1. Jesse Alan Slade Shantz
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  2. Jeff R. S. Leiter
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  3. Tania Gottschalk
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  4. Peter Benjamin MacDonald
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Correspondence to Jesse Alan Slade Shantz.

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Slade Shantz, J.A., Leiter, J.R.S., Gottschalk, T. et al. The internal validity of arthroscopic simulators and their effectiveness in arthroscopic education. Knee Surg Sports Traumatol Arthrosc 22, 33–40 (2014). https://doi.org/10.1007/s00167-012-2228-7

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  • DOI: https://doi.org/10.1007/s00167-012-2228-7

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