Kenneth A. Gustke
ORLANDO — Use of simulation training may supplement clinical learning and decrease the learning curve for residents and fellows in training, according to a presentation at the Current Concepts for Joint Replacement Winter Meeting.
Compared with cadaver labs, which lack pathology, provide minimal repetitive practice opportunities and are expensive, simulation training allows orthopedic surgeons “to learn new skills with no impact on patient care,” according to Kenneth A. Gustke, MD.
“You can practice as often as you want, you have no time pressure, you can make mistakes and you can get feedback,” Gustke said. “You can also improve your performance prior to actually working on patients. These can also be adjusted for fidelity, so that the skill level of the learner can be appropriate for that particular training.”
Gustke noted types of medical simulators include mannequins, screen-based simulators and virtual reality (VR) simulators. Open-based simulators incorporate 3-D glasses, simulator screens and haptic guidance to create an experience similar to that in the OR.
“You can actually have tools in your hand, which [are] the same tools that you would use in the operating room, attached to a haptic arm so you can actually feel the texture of the bone and going through a cutting slot, so you can actually learn how to do a total knee replacement before you ever get to the operating room,” he said.
Although VR also allows surgeons to perform simulated surgery with tools in their hands, he noted there is no haptic feedback, which is a key aspect of the learning experience.
“For simulators to be effective, they must be realistic,” Gustke said. “They have to have quality device that is similar or better than cadavers. They have to have haptic or force feedback to give a sense of texture and shape of the bone and provide spatial orientation.” – by Casey Tingle
Gustke KA. Paper 2. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 12-15, 2018; Orlando.
Disclosure: Gustke reports he receives salary, royalties for consulting and designs implants for Mako Surgical Corp. and Stryker; receives salary, royalties for consulting, teaching from and designs implants for OrthoSensor; receives consulting fees from OSSimTech; and receives salary for teaching and consulting from Zimmer Biomet.