Development of Feasible and Cost – effective Arthroscopic Skills Simulator and Simulator Class

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Department of Orthopaedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University

Project Title:

Development of Feasible and Cost – effective Arthroscopic Skills Simulator and Simulator Class

Researcher (s):

Ratthapoom Watcharopas, MD., Chusak Kijkunasathian, MD., Chalermchai Limitlaohaphan, MD., Nadhaporn Saengpetch, MD., Chatchawal Lertbusayanukul, MD., Chaiyanun Vijittrakarnrung, MD.

Purpose: Surgical simulation is an effective method to improve basic arthroscopic skills. It improves eye-hand coordination (psychomotor skill) and helps in precise manipulation with bimanual task. There are many commercial models available in the market but the price is expensive and is not easy to access. Thus, we developed a simple and cost-effective arthroscopic skills simulator using easily available materials and affordable portable arthroscopic camera with 30 degrees lens that is available commercially from online shopping platform.

Method: The first to fourth year orthopaedic residents (n=31) were recruited in the study. They practiced on their own hand skill without training for two arthroscopic tasks. The time to complete task was the main objective results. The confidence to perform the tasks was collected by using self evaluated form. Then they were trained in the simulator class those were basic theory of arthroscopic technique and arthroscopic rotator cuff repair technique. The in-house simulator for rotator cuff repair model were used to practice. After the training, finished, all participants were re-evaluate by using the same task. The post-class’ time to complete task with 2 items and self evaluated form, confidence, understandability were collected.

Results: The mean time to complete task of all participants was decreased significantly (p<0.001). For the task 1, the mean time to complete task were 41.3%,43.1%,56.9%,44.9% for resident year 1 to 4 respectively and the mean total time was 43.3%. The task 2, the mean time to complete task were 38.5%,41%,55.2%,48% for resident year 1 to 4 respectively and the total mean time was 46.3%. It showed that the arthroscopic skill had been improved significantly. The mean understandability of arthroscopic surgery for all level had increased from 2,86/5 to 4.86/5 (41.20% increment). The mean confidence for arthroscopic surgery for all level was also increased from 2.36 to 4.56/5 (48.2% increment).

Conclusions: This low-fidelity surgical simulator can be used in simulator class to improve basic arthroscopic skill, understanding and self -confidence in arthroscopic surgery of entry-level resident trainees.