Evaluating the skill curve of psychomotor skill acquisition in arthroscopy, using a virtual reality simulator in trainee doctors

Background Virtual reality (VR) simulation with haptic feedback has emerged as one of the most promising methods of teaching basic techniques in minimally invasive surgery (MIS). Simulation training in MIS procedures allows trainees to receive feedback without putting patients at risk and can assist in decreasing error rates and iatrogenic injury. Aims The aim of this study is to evaluate the learning curve in acquiring psychomotor skills required for shoulder arthroscopy using a VR device with haptic feedback. Methods The TolTech ArthroSim (Touch of Life Technologies, Inc., Aurora, Colorado) was selected as the simulator. Six repetitions of the same arthroscopic procedure were performed in a single one-hour session. The metrics included in this study were time taken to complete procedures in seconds. 24 trainee doctors without prior arthroscopy exposure were recruited in this study Results There is a relevant reduction in time taken throughout the training sessions. The largest reduction in time taken occurred in the first two repetitions going from 422.61s to 242.19s a reduction of 42.69 per cent. This reduction in time taken levels out after the fourth repetition. Conclusion There is a significant but steep learning curve in trainee doctors learning arthroscopy using VR simulator with haptic feedback which correlated with the first 40 minutes of training. Despite a large variation in innate arthroscopic skill, on average participants were able to significantly improve by the end of the study. There is also a reduction in the variation of arthroscopic skills between participants in later repetitions.