Efficacy of standardized training on a virtual reality simulator to advance knee and shoulder arthroscopic motor skills

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. Twenty residents and five experts in arthroscopy were included. All participants performed a test including knee -and shoulder arthroscopy tasks on a virtual reality knee- and shoulder arthroscopy simulator. The residents had to complete a competency based training program. Thereafter, the previously completed test was retaken. We evaluated the metric data of the simulator using a z-score and the Arthroscopic Surgery Skill Evaluation Tool (ASSET) to assess training effects in residents and performance levels in experts. The residents significantly improved from pre- to post training in the overall z-score: - 9.82 (range, - 20.35 to - 1.64) to - 2.61 (range, - 6.25 to 1.5); p