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Shoulder arthroscopy skills in medical students improved with simulator training
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LIVERPOOL, United Kingdom — Although medical students who rotated through orthopaedics improved their shoulder arthroscopy technique when they underwent either standard training or simulator training, results of a randomized control trial presented here showed students trained with a simulator completed their cases faster and with a mean of five fewer assists at the final assessment.
“We think, even with a low dose exposure to simulation of 4 hours, we were able to show that the performance overall increased and so did their speed, as well as the number of times they needed intervention,” Nicholas A. Ferran, MBBS, MSc (Orth Eng), FRCS, of the Bio Skills Lab at Leicester Royal Infirmary, in Leicester, United Kingdom, said in a presentation at the British Orthopaedic Association Annual Meeting.
The study involved 51 men and 55 women. After randomization, 50 students were in the non-simulator group and 56 students were in the simulator group. The groups were similar except there were slightly more right-handed students in the non-simulator group, according to the abstract.
Ferran and his colleagues checked the students before the study for handedness and their videogame experience and skills. None of the students had any prior arthroscopy experience.
After initial assessments, the non-simulator group underwent typical training for shoulder arthroscopy delivered in the orthopaedic block and the simulator group used a simulator for 1 hour per week for 4 weeks. The students then repeated their initial assessment by performing four tasks with a wet lab specimen, but were videoed from behind so the assessors could not tell which students they were viewing and could focus more on the students’ hands, Ferran said.
The videos were scored by two senior consultants.
Ferran said the primary outcome measure was the Global Rating Scale of Connecticut score and the score on another scale developed just for shoulder arthroscopy.
“When we looked at the results, on all outcome measures, both groups improved and part of that is the fact that they have experienced the initial assessment, so they have some learned behavior from that experience, and also the experience they gathered on the block. But what we saw was if we looked at the Connecticut score, the simulator students did statistically significantly better, and so with the shoulder score, as well, again with the simulator group doing statistically better than the non-simulator group,” Ferran said.
Training can perhaps be enhanced with the use of simulation, he said. – by Susan M. Rapp
Reference:
Ferran NA, et al. Paper #256. Presented at: British Orthopaedic Association Annual Congress; Sept. 15-18, 2015; Liverpool, United Kingdom.
Disclosure: Ferran reports he is an Arthrex Shoulder Fellow. The study used loan equipment from Storz Endoscopy and was funded by a grant from the Leicester Foxtrot Charity.