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What skills should simulation training in arthroscopy teach residents? A focus on resident input

  • Y. Hui
  • O. Safir
  • A. Dubrowski
  • H. Carnahan
Original Article

Abstract

Purpose

   Our purpose was to identify what surgical skills trainees consider important to possess before performing in the operating room and the components of an optimal simulator.

Methods

   An online survey composed of 35 questions was completed by 67 orthopedic residents from across Canada. The questions examined the opinions of residents for their perspective on what constitutes an optimal design of an arthroscopic simulator.

Results

   The average year of residency of the respondents was 3.2, and the average number of arthroscopies assisted on was 66.1 with a range of 0–300. Identification of structures and navigation of the arthroscope were ranked highly in terms of importance for trainee surgeons to possess before performing in the operating room. Higher fidelity simulation models such as cadaveric specimens or the use of synthetic knees were preferred over lower fidelity simulation models such as virtual reality simulators or bench top models.

Conclusion

   The information from trainees can be used in the development of a simulator for medical education as well as program and curriculum design. The report also highlights the importance of the pre-RCT phases leading to the development of the most effective simulation programs.

Keywords

Education Orthopedics Training  Simulation Virtual reality 

Notes

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Reznick RK, MacRae H (2006) Teaching surgical skills: changes in the wind. New Engl J Med 355:2664–2669PubMedCrossRefGoogle Scholar
  2. 2.
    Moorthy K, Munz Y, Sarker SK, Darzi A (2003) Clinical review objective assessment of technical skills in surgery. BMJ 327:1032–1037PubMedCrossRefGoogle Scholar
  3. 3.
    Ahmmad SNZ, Ming ESL, Fai YC, Harun FKBC (2011) Assessment methods for surgical skill. World Acad Sci Eng Technol 58:752–758Google Scholar
  4. 4.
    Chaudhry A, Sutton C, Wood J, Stone R, Mccloy R (1999) Learning rate for laparoscopic surgical skills on MIST VR, a virtual reality simulator: quality of human-computer interface. Ann R Coll Surg Engl 81:281–286PubMedGoogle Scholar
  5. 5.
    Safir O, Dubrowski A, Mirsky L, Lin C, Backstein D, Carnahan H (2008) What skills should simulation training in arthroscopy teach residents? Int J CARS 3:433–437CrossRefGoogle Scholar
  6. 6.
    Cook DA, Brydges R, Hamstra SJ, Zendejas B, Szostek JH, Wang AT, Erwin PJ, Hatala R (2012) Comparative effectiveness of technology-enhanced simulation versus other instructional methods: a systematic review and meta-analysis. Simul Healthc 7(5):308–20PubMedCrossRefGoogle Scholar
  7. 7.
    McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB (2011) Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 86(6):706–711. doi: 10.1097/ACM.0b013e318217e119 Google Scholar
  8. 8.
    Regehr G (2010) It’s NOT rocket science: rethinking our metaphors for research in health professions education. Med Educ 44(1):31–39. doi: 10.1111/j.1365-2923.2009.03418.x PubMed PMID: 20078754
  9. 9.
    Regehr G (2011) Highway spotters and traffic controllers: further reflections on complexity. Med Educ 45(6):542–543. doi: 10.1111/j.1365-2923.2011.04007.x Epub 2011 Apr 18. PunMed PMID: 21501221Google Scholar
  10. 10.
    Campbell M, Fitzpatrick R, Haines A, Kinmonth AL, Sandercock P, Spiegelhalter D, Tyrer P (2000) Framework for design and evaluation of complex interventions to improve health. BMJ 321(7262):694–696PubMedCrossRefGoogle Scholar
  11. 11.
    Ahmed K, Amer T, Challacombe B, Jaye P, Dasgupta P, Khan MS (2011) How to develop a simulation programme in urology. BJU Int 108(11):1698–1702. doi: 10.1111/j.1464-410X.2011.010420.x Epub 2011 Aug 22. ReviewPubMedCrossRefGoogle Scholar
  12. 12.
    Reznick RK (1993) Teaching and testing technical skills. Am J Surg 165(3):358–361PubMedCrossRefGoogle Scholar
  13. 13.
    Fitts PM, Posner (1967) Human performance. Brooks/Cole, BelmontGoogle Scholar
  14. 14.
    Guadagnoli MA, Lee TD (2004) Challenge point: a framework for conceptualizing the effects of various practice conditions in motor learning. J Mot Behav 36(2):212–24. doi: 10.3200/JMBR.36.2.212-224
  15. 15.
    Brydges R, Carnahan H, Rose D, Dubrowski A (2010) Comparing self-guided learning and educator-guided learning formats for simulation-based clinical training. J Adv Nurs 66(8):1832–44. doi: 10.1111/j.1365-2648.2010.05338.x
  16. 16.
    Brydges R, Carnahan H, Rose D, Rose L, Dubrowski A (2010) Coordinating progressive levels of simulation fidelity to maximize educational benefit. Acad Med 85(5):806–812PubMedCrossRefGoogle Scholar
  17. 17.
    Kirkpatrick DL, Kirkpatrick JD (2006) Evaluating training programs, 3rd edn. Berrett-Koehler Publishers, San Francisco, CAGoogle Scholar

Copyright information

© CARS 2013

Authors and Affiliations

  • Y. Hui
    • 1
    • 2
  • O. Safir
    • 2
    • 3
  • A. Dubrowski
    • 1
    • 2
    • 4
  • H. Carnahan
    • 1
    • 2
    • 5
  1. 1.The Centre for Ambulatory Care EducationWomen’s College HospitalTorontoCanada
  2. 2.The Wilson CentreUniversity of TorontoTorontoCanada
  3. 3.Department of SurgeryUniversity of TorontoTorontoCanada
  4. 4.The Learning Institute at the Hospital for Sick ChildrenUniversity of TorontoTorontoCanada
  5. 5.Department of Occupational Science and Occupational TherapyUniversity of TorontoTorontoCanada

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