Second Report of Shoulder Virtual Reality Arthroscopic Trainer

Abstract

Recently, shoulder arthroscopic surgery has been increasing. Due to the high degree of difficulty, technical mastery of the surgery takes experience of many cases and a long time. We had reported that, in Shoulder Virtual Reality Arthroscopic Trainer (VRAT), the shoulder surgeon's time spent for probing task was shorter than those of residents and medical students. In this study, we evaluated whether any level of arthroscopic experience correlated to the result of VRAT or not, using probing task and more difficult anchoring task, and spreading the subjects from novice to expert: total=53 orthopaedic surgeons, and we examined the validity of VRAT with questionnaires. Probe task: experience of under 500, the number of shoulder arthroscopic surgeries experience was correlated with Global Score (p=0.026, CR=0.376), Time(p=0.048, CR=-0.332), and Covered Distance: Camera (p=0.040, CR=-0.344), statistically. In the case of experience of over 500, that meant expert, no correlation was found between experienced number and any metric. Anchor Task: Experience of under 500, the experienced number was correlated with Global Score (p=0.019, CR=0.396) and Maximum distance to tear (p=0.004, CR=-0.479), statistically. Among experts, there was no correlation between experienced number of surgeries and any metric. We recognized VRAT could evaluate the level of shoulder arthroscopic skill from novice to advanced, but couldn't distinguish expert from advanced. We think another (more difficult) task is required to determine the difference of technical level in expert, or there is a plateau of learning curve about of experience 500 cases. Questionnaires showed that VRAT was very useful or useful for all from inexperienced to intermediate and advanced, but not necessarily so for the expert.
We think that VRAT would help improvement of arthroscopy technique and reduce the learning curve, so it would improve patient safety in the future, if it were established as the arthroscopy education system.