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Research Article

Orthopaedic Residents' Transfer of Knee Arthroscopic Abilities from the Simulator to the Operating Room

Ledermann, Gerardo MD; Rodrigo, Andrés; Besa, Pablo MD; Irarrázaval, Sebastián MD

Author Information

From the Orthopedic Surgery Department, Pontificia Universidad Católica de Chile, Santiago, Chile (Dr. Ledermann, Dr. Besa, and Dr. Irarrázaval), and School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile (Mr. Rodrigo).

Correspondence to Dr. Irarrázaval:[email protected]

Institutional orthopaedics department funding was used for this study.

None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Ledermann, Mr. Rodrigo, Dr. Besa, and Dr. Irarrázaval.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.jaaos.org).

Journal of the American Academy of Orthopaedic Surgeons28(5):p 194-199, March 1, 2020. |DOI:10.5435/JAAOS-D-19-00245
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Introduction: 

The ultimate goal for any surgical simulation program is to prove the capability of transferring the skills learned to real-life surgical scenarios. We designed an arthroscopic partial meniscectomy (APM) training program and sought to determine its ability to transfer skills to real patients.

Methods: 

Eleven junior orthopaedic residents and three expert knee surgeons were included. A low-fidelity knee simulator was used. Trainees had two baseline assessments of completing APM on a supervised real patient and on the simulator, measured using the Arthroscopic Surgical Skill Evaluation Tool (ASSET). After baseline, the trainees completed an APM training program and had a final evaluation of proficiency on the simulator and in real patients. Experts were also assessed for comparison. Statistical analysis was performed, assuming nonparametric behavior of variables.

Results: 

All trainees improved from a base score of 14 points in real patients and 10 points on the simulator to a final score of 39 points and 36 points, respectively (P < 0.01). The final trainee simulator score did not differ from experts on the simulator and was lower in real patients (36 versus 39 points, respectively,P ≤ 0.01), which resulted in a 92% transfer ratio for the simulator.

Discussion: 

Simulated training of APM in orthopaedic residents using a low-fidelity knee simulator proved to not only improve simulated proficiency but also successfully transfer skills to a real clinical scenario with a high model transfer ratio.

Level of Evidence: 

Level II (Prospective Cohort Study)

Copyright 2019 by the American Academy of Orthopaedic Surgeons.

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JAAOS - Journal of the American Academy of Orthopaedic Surgeons28(5):194-199, March 1, 2020.
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