Variation in Reported Learning Outcomes and Measurement Instruments in Hip Arthroscopy Simulation Training: A Systematic Review

Abstract

Purpose: To systematically review the current literature on the effectiveness of hip arthroscopy simulation training and to determine the consistency of reporting and validation of simulation used in hip arthroscopy.

Methods: Three databases (PubMed, EMBase, and CINAHL) were screened using PRISMA guidelines in January 2022 for published literature on virtual simulation in hip arthroscopy. Studies reporting on the use of hip arthroscopy simulation training in orthopedic surgical trainees were included and assessed for quality and risk of bias using MINORS criteria. The number of participants, participant education level, experience, simulator type, validation type, method of assessment, and simulation outcomes were extracted from included studies.

Results: Of the 286 articles screened, 11 met inclusion criteria for review evaluating 323 orthopedic trainees with a mean of 29.36 participants per study published between 2012 and 2021, most commonly in the United Kingdom (55%). The four most reported surgical skills evaluated were visualization and probing tasks (82%), mean time to perform the task (73%), number of cartilage and soft tissue collisions (73%), and number of hand movements (73%). The most described measurement instruments included a simulation built-in scoring system (55%), Arthroscopic Surgical Skill Evaluation Tool (ASSET) Global Rating Scale (GRS) (27%), and motion analysis system (18%). Construct validity was the most reported overall type of validity (82%), followed by face validity (36%), transfer validity (18%) and content validity (18%). Construct validity was also the most reported validity for the simulator and measurement instrument (55% and 89%, respectively).

Conclusions: There is significant variation in reported learning outcomes and measurement instruments for evaluating the effectiveness of hip arthroscopic-based education. This study highlights that simulation training may be an effective tool for evaluation of hip arthroscopy skills.

Level of evidence: Level III, systematic review of level I to III studies.