For total hip arthroplasty (THA), cognitive training prior to performing real surgery may be an effective adjunct alongside simulation to shorten the learning curve. This study sought to create a cognitive training tool to perform direct anterior approach THA, validated by expert surgeons; and test its use as a training tool compared to conventional material. We employed a modified Delphi method with four expert surgeons from three international centres of excellence. Surgeons were independently observed performing THA before undergoing semi-structured cognitive task analysis (CTA) before completing successive rounds of electronic surveys until consensus. The agreed CTA was incorporated into a mobile and web-based platform. Forty surgical trainees (CT1-ST4) were randomised to CTA-training or a digital op-tech with surgical videos, before performing a simulated DAA THA in a validated fully-immersive virtual reality simulator.Background
Methods
Virtual Reality (VR) uses headsets and motion-tracked controllers so surgeons can perform simulated total hip arthroplasty (THA) in a fully-immersive, interactive 3D operating theatre. The aim of this study was to investigate the effect of laboratory-based VR training on the ability of surgical trainees to perform direct anterior approach THA on cadavers. Eighteen surgical trainees (CT1-ST4) with no prior experience of direct anterior approach (DAA) THA completed an intensive 1-day course (lectures, dry-bone workshops and technique demonstrations). They were randomised to either a 5-week protocol of VR simulator training or conventional preparation (operation manuals and observation of real surgery). Trainees performed DAA-THA on cadaveric hips, assisted by a passive scrub nurse and surgical assistant. Performance was measured on the Intercollegiate Surgical Curriculum Project (ISCP) procedure-based assessment (PBA), on a 9-point global summary score (Table 1). This was independently assessed by 2 hip surgeons blinded to group allocation. The secondary outcome measure was error in cup orientation from a predefined target (40° inclination and 20° anteversion).Background
Methods
