Construct Validity and Experience of Using a Low-cost Arthroscopic Shoulder Surgery Simulator

Abstract

Objective To validate the low-cost model for arthroscopy training and analyze the acceptance and usefulness of the developed simulator in medical teaching and training. Method Ten medical students, ten third-year orthopedic residents, and ten shoulder surgeons performed predetermined tasks on a shoulder simulator twice. The parameters used were time to complete the tasks, number of looks at the hands, GOALS score (Global Operative Assessment of Laparoscopic Skills) and comparison between groups and within groups. An adapted Likert scale was applied addressing the individuals' impressions about the simulator and its applicability. Results In the intergroup comparison, the shoulder surgeons had better scores and times than the other groups. When the tasks were repeated, the group of surgeons had a 59% improvement in time (p < 0.05), as did the group of medical students. In the GOALS score, shoulder surgeons had consistently better scores than the other groups. And when we evaluated the evolution from the first to the second test, the group of surgeons and the group of academics had a statistically significant improvement (p < 0.05). In terms of lookdowns, there was a decrease in all groups. There was consensus that the simulator is useful in training. Conclusion The simulator developed allowed the differentiation between individuals with different levels of training in arthroscopic surgery. It was accepted by 100% of the participants as a useful tool in arthroscopic shoulder surgical training.

Keywords: arthroscopy; shoulder; simulation training; training technique.

Fig. 1

( a ) Fixation of the rotator cuff simulation tape, ( b ) Demonstration of the positions of the structures, ( c ) Positioning of the glenoid reference points. Source: Author (2021).

Fig. 2

Demonstration of model use ( a ) Ready-made shoulder arthroscopy training model; ( b ) model in use with arthroscope; ( c ) triangulation exercise with probe in lateral decubitus; ( d ) tissue manipulation exercise by elastic traction (supraspinal) in a beach chair. Source: Author (2021).

Fig. 3

Intergroup comparison, time in the first test. Source: The Author (2021). Comparação de tempos teste 1 = Time comparison, Test 1, Segundos = Seconds, Cirurgiões = Surgeons, Residentes = Residents, Acadêmicos = Medical students, Testes = Tests.

Fig. 4

Intergroup comparison, time in the second test. Source: The Author (2021). Comparação de tempos teste 2 = Time comparison, Test 2, Segundos = Seconds, Cirurgiões = Surgeons, Residente = Residents, Acadêmicos = Medical students, Testes = Tests.

Fig. 5

GOALS score variation between the first and second tests. Source: The Author (2021). GOALS primeiro e segundo testes = GOALS first and second tests, GOALS = GOALS, Cirurgiões T1 = Surgeons T1, Cirurgiões T2 = Surgeons T2, Residente T1 = Residents T1, Residente T2 = Residents T2, Acadêmicos T1 = Students T1, Acadêmicos T2 = Students T2, Testes = Tests.

Fig. 1

( a ) Fixação da fita de simulação de manguito rotador, ( b ) Demonstração das posições das estruturas, ( c ) Posicionamento dos pontos de referência da glenóide. Fonte: Autor (2021).

Fig. 2

Demonstração do uso do modelo ( a ) Modelo de treinamento em artroscopia de ombro pronto; ( b ) modelo em uso com artroscópio; ( c ) exercício de triangulação com “ probe ” em decúbito lateral; ( d ) exercício de manipulação de tecido por tração do elástico (supra espinhal) em cadeira de praia. Fonte: Autor (2021).

Fig. 3

Comparação tempos intergrupos primeira tentativa. Fonte: O Autor (2021).

Fig. 4

Comparação tempos intergrupos segunda tentativa. Fonte: O Autor (2021).

Fig. 5

Variação escore GOALS entre o primeiro e segundo teste. Fonte: O Autor (2021).