The validity of arthroscopic simulators and performance tools

As there is a growing demand for more time-efficient and effective methods for medical training without putting patients at risk, the role of simulation keeps expanding. Validation of simulators should precede implementation in medical curricula. However, only a small minority of available medical simulators is found to be (appropriately) validated. Researchers, manufacturers and medical trainers are therefore encouraged to collaborate to develop simulators, conduct proper validation studies and select the appropriate simulator. Especially in the field of arthroscopy, a lack of (properly validated) simulators exists. Two high-fidelity arthroscopic knee simulators are studied for face and construct validity, and a pilot study is conducted to develop a solid protocol for a large scale randomized controlled transfer validity study. The acquirement of arthroscopic skills is stimulated by the use of objective tools and metrics to monitor arthroscopic performance and provide feedback. As metrics and complementary thresholds for safety performance during arthroscopy are scarcely studied, maximum allowed forces for safe joint stressing are investigated. Moreover, construct validity of two Global Rating Scales, designed for evaluation of arthroscopic performance is studied. Although the number of (high-fidelity) arthroscopic simulators and performance tracking tools have recently increased, more evidence on their validity and usefulness of simulators and assessment tools is needed. Future studies should focus on high-quality study designs and standardized protocols in order to offer orthopedic residents an adequate training environment to acquire and maintain arthroscopic skills, and to enable performance tracking and proficiency assessment, with the ultimate goal to improve and secure patient safety