Kenneth A. Gustke
ORLANDO — Orthopedic surgeons who play a role in the training of residents and fellows are not only “guardians of patient care,” according to a presenter here, but are obligated to promote new ways to improve how the physicians who will success them are trained.
Better training modalities, such as simulators with haptic feedback and ones that use virtual reality goggles, are among the new training paradigms needed for total joint arthroplasty surgeons, Kenneth A. Gustke, MD, said at the Current Concepts in Joint Replacement Winter Meeting.
“The current training paradigm is now problematic because we have to be more concerned about patient safety and efficiency, but simulators need to be improved. We need to have more objective proof that they can actually improve clinical performance, but I think that is going to happen as simulators get better,” he said.
Eventually, when simulation training of all kinds is fully integrated into training programs so that it supplements clinical learning, the surgical learning curve will also decrease, Gustke said.
“So that when a first-year resident does his total knee, he’s done a total knee going through step-by-step on a simulator before he ever has his hands on a patient,” Gustke said.
He noted there are about 15 studies in the current hip, knee, shoulder and spine surgery literature related to training using simulators that “show variable construct and transference validity, and this can lead to improvement in technical skills, as reported in these articles.”
Gustke said features he would like to see in effective total joint arthroplasty simulators include haptics that enable orthopedic surgeons to use the same tools they would normally use for TJA and feel it hit against the “bone” and more realistic virtual reality goggles. – by Susan M. Rapp
Gustke KA. Paper 28. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 11-14, 2019; Orlando.
Disclosure: Gustke reports he receives salary and royalties for consulting and implant design from MAKO Surgical Corp. Stryker; receives a salary and royalty for consulting, teaching and implant design from OrthoSensor; receives consulting fees from OSSim Tech; and receives salary for teaching and consulting from Zimmer Biomet.