Comparison between virtual reality with bench-top simulation in the acquisition of arthroscopic skill: A meta-analysis of randomized controlled trials.

Abstract

BackgroundTo compare the effectiveness of VR simulation versus bench-top simulation in the acquisition and transfer of arthroscopic skills among surgical trainees.MethodsA systematic search was conducted across databases including PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials (RCTs) comparing VR and bench-top simulation training for arthroscopy. Studies involving surgical novices, such as medical students and residents with minimal prior arthroscopic experience, were included. Data extracted encompassed study design, participant demographics, intervention details, and outcome measures related to skill acquisition and transfer. The primary outcomes assessed were improvements in arthroscopic skills, procedural efficiency, and task accuracy. Secondary outcomes included skill transferability to cadaveric or live surgical settings, skill retention over time, and participant confidence levels. A random-effects model was utilized for meta-analysis, with standardized mean differences (SMD) and 95% confidence intervals (CI) calculated for continuous variables. Heterogeneity was assessed using the I² statistic.ResultsBoth VR and bench-top simulation training resulted in significant improvements in arthroscopic skills compared to baseline measurements. However, the VR simulation group consistently outperformed the bench-top model group in diagnostic arthroscopy crossover tests and in simulated cadaveric setups. Furthermore, the VR group demonstrated superior skill transfer in surprise skill transfer tasks. These findings suggest that while both simulation modalities are effective for arthroscopic skill acquisition, VR simulation may offer advantages in terms of skill transferability and overall performance enhancement.ConclusionsBoth VR and bench-top simulation trainings are effective in enhancing arthroscopic skills among surgical trainees. However, VR simulation demonstrates superior outcomes in skill acquisition and transferability to real-world surgical settings.