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Sports medicine expert Dr. Theodore Shybut

Just as pilots practice flying using a simulator, surgeons-in-training hone in on their skills using simulation tools. A new study by experts at Baylor College of Medicine found that orthopedic surgery residents made significant improvements on their knee and shoulder surgical skills using a virtual arthroscopic simulator. Their report recently was published in the Orthopaedic Journal of Sports Medicine.

Supported by a grant from the American Board of Orthopaedic Surgery, researchers measured the outcomes of orthopedic surgery residents training on the arthroscopic simulator. They grouped the residents based on their level of training, assessed their baseline skills on the simulator and then observed their skills after the residents completed several modules on the simulator.

They found trends showing junior residents, meaning those who were early in their training, made bigger gains on the knee simulator, and the senior residents made the biggest gains on the shoulder simulator.

“This fits with our traditional view that basic knee arthroscopy is more straightforward compared to learning arthroscopic shoulder surgery,” said Dr. Theodore Shybut, associate professor in the Joseph Barnhart Department of Orthopedic Surgery and a sports medicine expert at Baylor, who was the senior author of the paper. “Part of why this study was done was to understand if there are certain time points in training where the simulator makes the biggest difference and to work it into residency curriculum. This study gave us insight into how we do this in an intelligent, evidence-based way.”

Shybut, who performs surgeries at Baylor St. Luke’s Medical Center, noted that this study was done in a small group of residents and that simulation is still different than performing surgery in the operating room.

“A follow-up to this would be to see if the gains on the simulator would actually help the residents in the operating room,” Shybut said. “This study is a good baseline that validates the use of simulator labs to teach basic surgical skills.”

Another benefit to using the simulator is that the software can be updated to include additional procedures for residents to practice their skills, he said.

Others who took part in the study include Dr. Shahram Yari, Dr. Chanakya Jandhyala and Dr. Behnam Sharareh from Baylor and Dr. Aravind Athiviraham from the University of Chicago.

The study was supported by a research grant from the American Board of Orthopaedic Surgery.