Training safer orthopedic surgeons Construct validation of a virtual-reality simulator for hip fracture surgery
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Published version
Author(s)
Type
Journal Article
Abstract
Background and purpose — Virtual-reality (VR) simulation in
orthopedic training is still in its infancy, and much of the work has
been focused on arthroscopy. We evaluated the construct validity
of a new VR trauma simulator for performing dynamic hip screw
(DHS) fixation of a trochanteric femoral fracture.
Patients and methods — 30 volunteers were divided into 3
groups according to the number of postgraduate (PG) years and
the amount of clinical experience: novice (1–4 PG years; less than
10 DHS procedures); intermediate (5–12 PG years; 10–100 procedures);
expert (> 12 PG years; > 100 procedures). Each participant
performed a DHS procedure and objective performance
metrics were recorded. These data were analyzed with each performance
metric taken as the dependent variable in 3 regression
models.
Results — There were statistically significant differences in
performance between groups for (1) number of attempts at guidewire
insertion, (2) total fluoroscopy time, (3) tip-apex distance,
(4) probability of screw cutout, and (5) overall simulator score.
The intermediate group performed the procedure most quickly,
with the lowest fluoroscopy time, the lowest tip-apex distance,
the lowest probability of cutout, and the highest simulator score,
which correlated with their frequency of exposure to running the
trauma lists for hip fracture surgery.
Interpretation — This study demonstrates the construct validity
of a haptic VR trauma simulator with surgeons undertaking
the procedure most frequently performing best on the simulator.
VR simulation may be a means of addressing restrictions
on working hours and allows trainees to practice technical tasks
without putting patients at risk. The VR DHS simulator evaluated
in this study may provide valid assessment of technical skill.
orthopedic training is still in its infancy, and much of the work has
been focused on arthroscopy. We evaluated the construct validity
of a new VR trauma simulator for performing dynamic hip screw
(DHS) fixation of a trochanteric femoral fracture.
Patients and methods — 30 volunteers were divided into 3
groups according to the number of postgraduate (PG) years and
the amount of clinical experience: novice (1–4 PG years; less than
10 DHS procedures); intermediate (5–12 PG years; 10–100 procedures);
expert (> 12 PG years; > 100 procedures). Each participant
performed a DHS procedure and objective performance
metrics were recorded. These data were analyzed with each performance
metric taken as the dependent variable in 3 regression
models.
Results — There were statistically significant differences in
performance between groups for (1) number of attempts at guidewire
insertion, (2) total fluoroscopy time, (3) tip-apex distance,
(4) probability of screw cutout, and (5) overall simulator score.
The intermediate group performed the procedure most quickly,
with the lowest fluoroscopy time, the lowest tip-apex distance,
the lowest probability of cutout, and the highest simulator score,
which correlated with their frequency of exposure to running the
trauma lists for hip fracture surgery.
Interpretation — This study demonstrates the construct validity
of a haptic VR trauma simulator with surgeons undertaking
the procedure most frequently performing best on the simulator.
VR simulation may be a means of addressing restrictions
on working hours and allows trainees to practice technical tasks
without putting patients at risk. The VR DHS simulator evaluated
in this study may provide valid assessment of technical skill.
Date Issued
2015-09-01
Date Acceptance
2015-03-09
Citation
ACTA ORTHOPAEDICA, 2015, 86 (5), pp.616-621
ISSN
1745-3674
Publisher
Taylor & Francis
Start Page
616
End Page
621
Journal / Book Title
ACTA ORTHOPAEDICA
Volume
86
Issue
5
Copyright Statement
© Nordic Orthopaedic Federation. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use,
distribution, and reproduction in any medium, provided the source is credited.
distribution, and reproduction in any medium, provided the source is credited.
License URL
Subjects
Science & Technology
Life Sciences & Biomedicine
Orthopedics
PERFORMANCE
Publication Status
Published