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Animation and Surgical Simulation in Orthopedic Education

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Sports Injuries

Abstract

The mastery of rapidly evolving orthopedic surgical techniques requires a long period of rigorous training. Recently implemented work-hour restrictions, mounting cost pressures, and patient safety concerns challenge trainees to acquire more complex surgical skills in a shorter amount of time. To meet these demands, educators have turned to alternative methods for surgical skills training outside of the operating room. These methods include hands-on training in specially designed surgical skills labs with cadavers, synthetic bones, anatomic models, or simulators. Computerized surgical simulators harness the power of advanced computer-generated imaging to render realistic medical animations for virtual reality training in a safe, controlled setting. There is a growing body of evidence supporting the educational advantages of surgical simulation in orthopedic skills training. However, questions remain regarding the validity and reliability of surgical simulation training in orthopedic surgery and if the skills acquired in the lab are transferrable to the operating room. Despite this, positive effects on the overall education of orthopedic residents, and on maintaining the proficiency of practicing orthopedic surgeons, are anticipated.

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Abbreviations

2D:

Two dimensional

3D:

Three dimensional

AANA:

Arthroscopy Association of North America

AAOS:

American Academy of Orthopaedic Surgery

ACGME:

Accreditation Council for Graduate Medical Education

AOA:

American Orthopaedic Association

CGI:

Computer-generated imaging

COE:

Council on Education

CRD:

Council of Residency Directors

FAST:

Fundamentals of Arthroscopic Surgery Training

GRS:

Global rating scales

HTML:

Hypertext markup language

IAA:

Interactive anatomical animation

KAST:

Knee Arthroscopy Surgical Trainer

OLC:

Orthopaedic Learning Center

OR:

Operating room

OSATS:

Objective structured assessment of technical skills

PASSPORT:

Practice Arthroscopic Surgical Skills for Perfect Operative Real-Life Treatment

PC:

Personal computer

RRC:

Residency Review Committee

VR:

Virtual reality

References

  • Atesok K, Schemitsch EH (2010) Computer-assisted trauma surgery. J Am Acad Orthop Surg 18:247–258

    Article  Google Scholar 

  • Atesok K, Mabrey JD, Jazrawi LM, Egol KA (2012) Surgical simulation in orthopaedic skills training. J Am Acad Orthop Surg 20:410–422

    Google Scholar 

  • Backstein D, Agnidis Z, Regehr G, Reznick R (2004) The effectiveness of video feedback in the acquisition of orthopedic technical skills. Am J Surg 187:427–432

    Article  Google Scholar 

  • Bergeson RK, Schwend RM, DeLucia T, Silva SR, Smith JE, Avilucea FR (2008) How accurately do novice surgeons place thoracic pedicle screws with the free hand technique? Spine (Phila Pa 1976) 33:E501–E507

    Article  Google Scholar 

  • Blyth P, Stott NS, Anderson IA (2007) A simulation-based training system for hip fracture fixation for use within the hospital environment. Injury 38:1197–1203

    Article  CAS  Google Scholar 

  • Citak M, Gardner MJ, Kendoff D, Tarte S, Krettek C, Nolte LP et al (2008) Virtual 3D planning of acetabular fracture reduction. J Orthop Res 26:547–552

    Article  Google Scholar 

  • Datta V, Chang A, Mackay S, Darzi A (2002) The relationship between motion analysis and surgical technical assessments. Am J Surg 184:70–73

    Article  Google Scholar 

  • Drake FT, Van Eaton EG, Huntington CR, Jurkovich GJ, Aarabi S, Gow KW (2012) ACGME case logs: surgery resident experience in operative trauma for two decades. J Trauma Acute Care Surg 73:1500–1506

    Article  Google Scholar 

  • Engels PT, de Gara C (2010) Learning styles of medical students, general surgery residents, and general surgeons: implications for surgical education. BMC Med Educ 10:51

    Article  Google Scholar 

  • Ferrari G (1987) Public anatomy lessons and the carnival: the anatomy theatre of Bologna. Past Present 117:50–106

    Article  Google Scholar 

  • Flores RL, Demoss P, Klene C, Havlik RJ, Tholpady S (2013) Digital animation versus textbook in teaching plastic surgery techniques to novice learners. Plast Reconstr Surg 132:101e–109e

    Article  CAS  Google Scholar 

  • Gofton W, Dubrowski A, Tabloie F, Backstein D (2007) The effect of computer navigation on trainee learning of surgical skills. J Bone Joint Surg Am 89:2819–2827

    Article  Google Scholar 

  • Gomoll AH, O’Toole RV, Czarnecki J, Warner JJ (2007) Surgical experience correlates with performance on a virtual reality simulator for shoulder arthroscopy. Am J Sports Med 35:883–888

    Article  Google Scholar 

  • Grantcharov TP (2008) Is virtual reality simulation an effective training method in surgery? Nat Clin Pract Gastroenterol Hepatol 5:232–233

    Article  Google Scholar 

  • Guttmann D, Graham RD, MacLennan MJ, Lubowitz JH (2005) Arthroscopic rotator cuff repair: the learning curve. Arthroscopy 21:394–400

    Article  Google Scholar 

  • Hall MP, Kaplan KM, Gorczynski CT, Zuckerman JD, Rosen JE (2010) Assessment of arthroscopic training in U.S. orthopedic surgery residency programs–a resident self-assessment. Bull NYU Hosp Jt Dis 68:5–10

    Google Scholar 

  • Holland JP, Waugh L, Horgan A, Paleri V, Deehan DJ (2011) Cadaveric hands-on training for surgical specialties: is this back to the future for surgical skills development? J Surg Educ 68:110–116

    Article  Google Scholar 

  • Howells NR, Gill HS, Carr AJ, Price AJ, Rees JL (2008) Transferring simulated arthroscopic skills to the operating theatre: a randomised blinded study. J Bone Joint Surg Br 90:494–499

    Article  CAS  Google Scholar 

  • Karam MD, Pedowitz RA, Natividad H, Murray J, Marsh JL (2013) Current and future use of surgical skills training laboratories in orthopaedic resident education: a national survey. J Bone Joint Surg Am 95:e4

    Article  Google Scholar 

  • Kim S, Bosque J, Meehan JP, Jamali A, Marder R (2011) Increase in outpatient knee arthroscopy in the United States: a comparison of National Surveys of Ambulatory Surgery, 1996 and 2006. J Bone Joint Surg Am 93:994–1000

    Article  Google Scholar 

  • Korndorffer JR Jr, Dunne JB, Sierra R, Stefanidis D, Touchard CL, Scott DJ (2005) Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg 201:23–29

    Article  Google Scholar 

  • Leahy M (2012) Using simulation, metrics to improve orthopaedic surgical skills. AAOS Now

    Google Scholar 

  • Leong JJ, Leff DR, Das A, Aggarwal R, Reilly P, Atkinson HD et al (2008) Validation of orthopaedic bench models for trauma surgery. J Bone Joint Surg Br 90:958–965

    Article  CAS  Google Scholar 

  • Mabrey JD, Reinig KD, Cannon WD (2010) Virtual reality in orthopaedics: is it a reality? Clin Orthop Relat Res 468:2586–2591

    Article  Google Scholar 

  • Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C et al (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273–278

    CAS  Google Scholar 

  • Martin KD, Belmont PJ, Schoenfeld AJ, Todd M, Cameron KL, Owens BD (2011) Arthroscopic basic task performance in shoulder simulator model correlates with similar task performance in cadavers. J Bone Joint Surg Am 93:e1271–e1275

    Article  Google Scholar 

  • Martin KD, Cameron K, Belmont PJ, Schoenfeld A, Owens BD (2012) Shoulder arthroscopy simulator performance correlates with resident and shoulder arthroscopy experience. J Bone Joint Surg Am 94:e160

    Article  Google Scholar 

  • McCarthy AD, Moody L, Waterworth AR, Bickerstaff DR (2006) Passive haptics in a knee arthroscopy simulator: is it valid for core skills training? Clin Orthop Relat Res 442:13–20

    Google Scholar 

  • McGhee J (2010) 3-D visualization and animation technologies in anatomical imaging. J Anat 216:264–270

    Article  Google Scholar 

  • Modi CS, Morris G, Mukherjee R (2010) Computer-simulation training for knee and shoulder arthroscopic surgery. Arthroscopy 26:832–840

    Article  Google Scholar 

  • O’Neill PJ, Cosgarea AJ, Freedman JA, Queale WS, McFarland EG (2002) Arthroscopic proficiency: a survey of orthopaedic sports medicine fellowship directors and orthopaedic surgery department chairs. Arthroscopy 18:795–800

    Article  Google Scholar 

  • Panait L, Akkary E, Bell RL, Roberts KE, Dudrick SJ, Duffy AJ (2009) The role of haptic feedback in laparoscopic simulation training. J Surg Res 156:312–316

    Article  Google Scholar 

  • Pedowitz RA, Marsh JL (2012) Motor skills training in orthopaedic surgery: a paradigm shift toward a simulation-based educational curriculum. J Am Acad Orthop Surg 20:407–409

    Article  Google Scholar 

  • Pedowitz RA, Esch J, Snyder S (2002) Evaluation of a virtual reality simulator for arthroscopy skills development. Arthroscopy 18:E29

    Article  Google Scholar 

  • Pellegrini CA, Warshaw AL, Debas HT (2004) Residency training in surgery in the 21st century: a new paradigm. Surgery 136:953–965

    Article  Google Scholar 

  • Poss R, Mabrey JD, Gillogly SD, Kasser JR, Sweeney HJ, Zarins B et al (2000) Development of a virtual reality arthroscopic knee simulator. J Bone Joint Surg Am 82-A:1495–1499

    Article  Google Scholar 

  • Regehr G, MacRae H, Reznick RK, Szalay D (1998) Comparing the psychometric properties of checklists and global rating scales for assessing performance on an OSCE-format examination. Acad Med 73:993–997

    Article  CAS  Google Scholar 

  • Reznick RK (1993) Teaching and testing technical skills. Am J Surg 165:358–361

    Article  CAS  Google Scholar 

  • Rogers C (1999) Surgical VR gets real. In: Canale, TS (ed.). Bulletin of the AAOS. American Academy of Orthopaedic Surgeons, Rosemont Canale, TS

    Google Scholar 

  • Rosser JC Jr, Lynch PJ, Cuddihy L, Gentile DA, Klonsky J, Merrell R (2007) The impact of video games on training surgeons in the 21st century. Arch Surg 142:181–186, discussion 6

    Article  Google Scholar 

  • Salkini MW, Doarn CR, Kiehl N, Broderick TJ, Donovan JF, Gaitonde K (2010) The role of haptic feedback in laparoscopic training using the LapMentor II. J Endourol 24:99–102

    Article  Google Scholar 

  • Sonnadara RR, Van Vliet A, Safir O, Alman B, Ferguson P, Kraemer W et al (2011) Orthopedic boot camp: examining the effectiveness of an intensive surgical skills course. Surgery 149:745–749

    Article  Google Scholar 

  • Sonnadara R, Rittenhouse N, Khan A, Mihailidis A, Drozdzal G, Safir O et al (2012a) A novel multimodal platform for assessing surgical technical skills. Am J Surg 203:32–36

    Article  Google Scholar 

  • Sonnadara RR, Garbedian S, Safir O, Nousiainen M, Alman B, Ferguson P et al (2012b) Orthopaedic Boot Camp II: examining the retention rates of an intensive surgical skills course. Surgery 151:803–807

    Article  Google Scholar 

  • Sonnadara RR, Garbedian S, Safir O, Mui C, Mironova P, Nousiainen M et al (2013) Toronto Orthopaedic Boot Camp III: examining the efficacy of student-regulated learning during an intensive, laboratory-based surgical skills course. Surgery 154:29–33

    Article  Google Scholar 

  • Tashiro Y, Miura H, Nakanishi Y, Okazaki K, Iwamoto Y (2009) Evaluation of skills in arthroscopic training based on trajectory and force data. Clin Orthop Relat Res 467:546–552

    Article  Google Scholar 

  • Tuijthof GJ, van Sterkenburg MN, Sierevelt IN, van Oldenrijk J, Van Dijk CN, Kerkhoffs GM (2010) First validation of the PASSPORT training environment for arthroscopic skills. Knee Surg Sports Traumatol Arthrosc 18:218–224

    Article  Google Scholar 

  • Tuijthof GJ, Visser P, Sierevelt IN, Van Dijk CN, Kerkhoffs GM (2011) Does perception of usefulness of arthroscopic simulators differ with levels of experience? Clin Orthop Relat Res 469:1701–1708

    Article  Google Scholar 

  • van der Meijden OA, Schijven MP (2009) The value of haptic feedback in conventional and robot-assisted minimal invasive surgery and virtual reality training: a current review. Surg Endosc 23:1180–1190

    Article  Google Scholar 

  • Van Heest A, Putnam M, Agel J, Shanedling J, McPherson S, Schmitz C (2009) Assessment of technical skills of orthopaedic surgery residents performing open carpal tunnel release surgery. J Bone Joint Surg Am 91:2811–2817

    Article  Google Scholar 

  • Wang B, Lu G, Patel AA, Ren P, Cheng I (2011) An evaluation of the learning curve for a complex surgical technique: the full endoscopic interlaminar approach for lumbar disc herniations. Spine J 11:122–130

    Article  Google Scholar 

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Correspondence to Theodore S. Wolfson .

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Wolfson, T.S., Atesok, K.I., Turhan, C., Mabrey, J.D., Egol, K.A., Jazrawi, L.M. (2015). Animation and Surgical Simulation in Orthopedic Education. In: Doral, M.N., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36569-0_245

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  • DOI: https://doi.org/10.1007/978-3-642-36569-0_245

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