Dr. Robert T. Burks, M.D., Dept. of orthopedic surgery, University of Utah, USA
The ability of the simulator to show a large number of different pathologies, to identify them and to document them distinguishes the VirtaMed ArthroS™ from training on conventional models, but also from training in the operating room or on cadavers where this high number of variability is not present. This is really what makes the VirtaMed ArthroS™ a unique training tool.
Fundamentals of arthroscopic surgery
Arthroscopy: basic skills
Acquiring basic arthroscopic skills requires a commitment to learning and many repetitions of the same interventions. The new basic skill training on the VirtaMed ArthroS™ simulator makes climbing up the learning curve fun. Exercises are great for honing your skills, as illustrated by "catch the stars", where stars are hidden below the meniscus, between ligaments, or bones.
The SimProctor™, a great teaching feature, shows the trainee exactly how to perform a correct diagnostic tour through different portals. The SimProctor™ uses ghost tools and colored hints to speed up learning. Trainees understand the concept of triangulation and can handle instruments without causing damage inside the joint.
Diagnostic arthroscopy
Varying levels of difficulty offer trainees the chance to perform complete diagnostic arthroscopic interventions. For knee arthroscopy training, patient cases include different meniscus lesions, an unhappy triad, chondromalacia, and arthrosis grade I-IV. For shoulder arthroscopy training, patient cases include different lesions in the rotator cuff, SLAP II, Bankart lesion, and impingement syndrome. Both knee and shoulder modules also include the case "Unknown pathology", which will introduce a random patient case for the trainee to recognize and diagnose.
The new teaching feature SimProctor™ takes over some of the teaching and mentoring done by senior medical staff. The SimProctor™ highlights regions such as patella, meniscus, or different ligaments. A feedback report is generated after each virtual procedure, rating surgical skills including safe handling of instruments and unintended collisions with tissue or bones.
Surgical knee and shoulder arthroscopy
Over 20 patients with various lesions in different locations provide training for the first steps in operative arthroscopy using original instruments like an arthroscope, punch, grasper, or shaver. The arthroscopy course curriculum includes different meniscus lesions, synovitial membrane inflammations, subacromial debridement, decompression, and loose body removal.
Again, the SimProctor™ offers helpful support. It shows the trainee with ghost views how to hold instruments, how to the bend knee or shoulder, and where to cut, shave, and/or grasp.
ACL reconstruction
Our latest addition to the ArthroS™ Knee module is the supplementary ACL Reconstruction Module. In this module the surgeon gets to diagnose an ACL tear, remove the injured ligament, and find the optimal locations to drill holes in the femur and tibia bones for the replacement graft.
The accompanying didactic slides teach trainees the basic concepts of ACL reconstruction, while the simulator's outside view and the 3-D training module help the trainee understand how slight changes in the replacement graft's location can affect the joint function.
VirtaMed ArthroS™ with knee model
The VirtaMed ArthroS™ platform can come with a knee and/or shoulder and/or hip and/or ankle model. The switch between the four models can be easily done in 30 seconds.
The knee, shoulder, hip, and ankle model with magnetic tracking provide realistic tactile sensation.
For an optimal learning experience, the trainee uses original OR instruments and tools such as an original arthroscope, palpation hook, grasper, cutting punch, or shaver. The instruments are equipped with sensors and allow for fluid handling, camera technique, and familiarize trainees with the concept of 0, 30, and 70-degree optics.
The anatomic model and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.
VirtaMed ArthroS™ with shoulder model
The VirtaMed ArthroS™ platform comes with either a knee and/or shoulder and/or hip and/or ankle model. The switch between the four models can be easily done in 30 seconds.
The knee, shoulder, hip, and ankle model come with magnetic tracking that provides realistic tactile sensation. For the shoulder and hip model, lateral decubitus and beach chair positions are also supported.
For an optimal learning experience, the trainee uses original OR instruments and tools such as an original arthroscope, palpation hook, grasper, cutting punch, or shaver. The instruments are equipped with sensors and allow for fluid handling and camera technique. Trainees are also familiarized with the concept of 0, 30 and 70-degree optics.
The anatomic model and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.
VirtaMed ArthroS™ with hip model
The VirtaMed ArthroS™ platform comes with either a knee and/or shoulder and/or hip and/or ankle model. The switch between the four models can be easily done in 30 seconds.
The knee, shoulder, hip, and ankle model come with magnetic tracking that provides realistic tactile sensation. For the hip and shoulder model, lateral decubitus and beach chair positions are also supported.
For an optimal learning experience, the trainee uses original OR instruments and tools such as an original arthroscope, palpation hook, grasper, cutting punch, or shaver. The instruments are equipped with sensors and allow for fluid handling and camera technique. Trainees are also familiarized with the concept of 0, 30 and 70-degree optics.
The anatomic model and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.
VirtaMed ArthroS™ with ankle model
The VirtaMed ArthroS™ platform can come with a knee and/or shoulder and/or hip and/or ankle model. The switch between the four models can be easily done in 30 seconds.
The knee, shoulder, hip, and ankle model with magnetic tracking provide realistic tactile sensation.
For an optimal learning experience, the trainee uses original OR instruments and tools such as an original arthroscope, palpation hook, grasper, cutting punch, or shaver. The instruments are equipped with sensors and allow for fluid handling, camera technique, and familiarize trainees with the concept of 0, 30, and 70-degree optics.
The anatomic model and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.
VirtaMed ArthroS™ FAST model
This virtual reality module is based on the Sawbones FAST workstation, which was developed under the guidance of AANA and an ABOS task force. Surgeons can now practice the basic skills needed before they actually go on and perform complex knee or shoulder arthroscopies.
The basic motor skill training tasks on the FAST workstation guide the trainee through the first steps of arthroscopy. Trainees learn which portal to choose and how to perform a correct access. Basic camera navigation tasks include steadiness and image centering, horizon control, periscoping and telescoping. They also learn to use different camera optics and the use of both hands for camera handling, thus allowing for the training of the dominant and non-dominant hand. Trainees get to know how to detect and center an object, probe and measure static objects, and develop triangulation skills.
The workstation and a high-end PC are mounted on a movable display cart with height-adjustable 23” multi touch-screen.
Efficacy of standardized training on a virtual reality simulator to advance knee and shoulder arthroscopic motor skills
Stefan Rahm, Karl Wieser, David E. Bauer, Felix WA Waibel, Dominik C. Meyer, Christian Gerber and Sandro F. Fucentese
Most studies demonstrated, that training on a virtual reality based arthroscopy simulator leads to an improvement of technical skills in orthopaedic surgery. However, how long and what kind of training is optimal for young residents is unknown. In this study we tested the efficacy of a standardized, competency based training protocol on a validated virtual reality based knee- and shoulder arthroscopy simulator.Fundamentals of Arthroscopic Surgery Training Program Improves Knee Arthroscopy Simulator Performance in Arthroscopic Trainees.
Cychosz CC, Tofte JN, Johnson A, Gao Y, Phisitkul P.
Determine the effectiveness of a nonanatomic simulator in developing basic arthroscopy motor skills transferable to an anatomic model.Virtual Reality Surgical Simulation for Arthroscopy Training
Robert A. Pedowitz
There is little doubt that the medical profession stands at a major crossroads with regards to the fundamental structure of surgical education. Although the apprenticeship model has been used for centuries, we are rapidly moving toward a new era of proficiencybased education. This transition is motivated by several important factors, including greater emphasis upon patient safety, increased focus on educational efficacy, and a shift toward objectively measured performance outcomes (i.e., demonstration of clinical proficiency). At the same time, the paradigm shift is challenged by limitations imposed by trainee work hour restrictions and by the initial investments and ongoing expenses associated with implementation of new training paradigms.Which Global Rating Scale? A Comparison of the ASSET, BAKSSS, and IGARS for the Assessment of Simulated Arthroscopic Skills.
Middleton RM, Baldwin MJ, Akhtar K, Alvand A, Rees JL
BACKGROUND: With the move to competency-based models of surgical training, a number of assessment methods have been developed. Of these, global rating scales have emerged as popular tools, and several are specific to the assessment of arthroscopic skills. Our aim was to determine which one of a group of commonly used global rating scales demonstrated superiority in the assessment of simulated arthroscopic skills.Validation of the updated ArthroS simulator: face and construct validity of a passive haptic virtual reality simulator with novel performance metrics
Patrick Garfjeld Roberts, Paul Guyver, Mathew Baldwin, Kash Akhtar, Abtin Alvand, Andrew J. Price, Jonathan L. Rees
Purpose: To assess the construct and face validity of ArthroS, a passive haptic VR simulator. A secondary aim was to evaluate the novel performance metrics produced by this simulator.Knee, Shoulder, and Fundamentals of Arthroscopic Surgery Training: Validation of a Virtual Arthroscopy Simulator
Josef N. Tofte, Brian O. Westerlind, Kevin D. Martin, Brian L. Guetschow, Bastián Uribe-Echevarria, Chamnanni Rungprai, Phinit Phisitkul
Purpose: To validate the knee, shoulder, and virtual Fundamentals of Arthroscopic Training (FAST) modules on a virtual arthroscopy simulator via correlations with arthroscopy case experience and postgraduate year.Comparison Of Three Virtual Reality Arthroscopic Simulators As Part Of An Orthopedic Residency Educational Curriculum
Kevin D Martin, DO, MAJ, MC, Craig C Akoh, MD, Annunziato Amendola, MD, Phinit Phisitkul, MD
Orthopedic education continues to move towards evidence-based curriculum in order to comply with new residency accreditation mandates. There are currently three high fidelity arthroscopic virtual reality (VR) simulators available, each with multiple instructional modules and simulated arthroscopic procedures. The aim of the current study is to assess face validity, defined as the degree to which a procedure appears effective in terms of its stated aims, of three available VR simulators.Asymmetry in Dominant / Non-Dominant Hand Performance Differentiates Novices from Experts on an Arthroscopy Virtual Reality Serious Game
Robert PEDOWITZ, MD, PhD, Gregg NICANDRI, MD, and Stefan TUCHSCHMID, PhD
Safe and effective arthroscopic surgery requires ambidextrous motor skills. The current study examined dominant versus non-dominant hand performance on a virtual reality serious game in a group of expert arthroscopic surgeons (n=15) compared to a group of orthopedic surgery residents (n=10).Validation of a virtual reality-based simulator for shoulder arthroscopy
Stefan Rahm, Marco Germann, Andreas Hingsammer, Karl Wieser, Christian Gerber
This study was to determine face and construct validity of a new virtual reality-based shoulder arthroscopy simulator which uses passive haptic feedback.Evaluation of a virtual-reality-based simulator using passive haptic feedback for knee arthroscopy
Sandro F. Fucentese, Stefan Rahm, Karl Wieser, Jonas Spillmann, Matthias Harders, Peter P. Koch
Simulator training in orthopaedics is still in its infancy. The aim of this study is to determine face and construct validity of a new virtual reality simulator (VirtaMed ArthroS™) for diagnostic and therapeutic knee arthroscopy by analysis of simulator metrics of participants with varying arthroscopy experience.Reference Center University of Missouri Kansas City School of Medicine
Founded in 1971, UMKC's School of Medicine has always been ahead of the curve in training physicians. The School’s innovative curriculum provides students with early and continuous patient-care experience and fully integrates liberal arts/humanities, basic sciences and clinical medicine. The learning environment de-emphasizes competition and encourages learning through close faculty-student interaction and student partnerships.
Reference Center Orthopaedic Research Institute of Bournemouth University, UK
The Orthopaedic Research Institute of Bournemouth University is the first place in the world to train on their own VirtaMed ArthroS™ hip simulator. Profs. Rob Middleton and Tom Wainwright from BUORI know how difficult it is to train for the keyhole surgery that hip arthroscopy needs, and want to provide their trainees the opportunity to do so. The orthopedic surgeons at BUORI continue to help VirtaMed develop the hip to the needs of physicians.
Reference Center University of Utah, USA
The University of Utah wanted to enhance surgical education in the orthopedic department. The goal is simply to use the latest educational means available for the training of young surgeons, i.e. virtual reality simulators. After comparing the different simulators currently on the market and their training abilities, the decision was clear. Watch the video below and see why Dr. Burks of the Department of Orthopaedic Surgery prefers the VirtaMed ArthroS™ arthroscopy simulator over other training tools.
Reference Center Würzburg, Germany
As the very first hospital in Germany, König-Ludwig-Haus uses the arthroscopy simulator VirtaMed ArthroS™ for the education of resident physicians. The simulator is an inherent part of the curriculum and receives positive feedback from young surgeons. Dr. Stephan Reppenhagen also perceives a positive effect on the learning curve of young physicians, way before their first guided procedure in the operating room.
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