Assessment of learning in simulator-based arthroscopy training with the diagnostic arthroscopy skill score (DASS) and neurophysiological measures.
Arthroscopy
Computer-assisted
Education
Near-infrared
Neurophysiological techniques
Spectroscopy
Task performance and analysis
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
30
05
2023
accepted:
02
09
2023
pubmed:
25
9
2023
medline:
25
9
2023
entrez:
24
9
2023
Statut:
ppublish
Résumé
Virtual arthroscopic training has become increasingly popular. However, there is a lack of efficiency-based tracking of the trainee, which may be critical for determining the specifics of training programs and adapting them for the needs of each trainee. This study aims to evaluate and compare the measures obtained with a non-invasive neurophysiological method with The Diagnostic Arthroscopy Skill Score (DASS), a commonly used assessment tool for evaluating arthroscopic skills. The study collected simulator performance scores, consisting of "Triangulation Right Hand", "Triangulation Left Hand", "Catch the Stars" and "Three Rings" and DASS scores from 22 participants (11 novices, 11 experts). These scores were obtained while participants underwent a structured program of exercises for the fundamentals of arthroscopic surgery training (FAST) and knee module using a simulator-based arthroscopy device. During the evaluation, data on oxy-hemoglobin and deoxy-hemoglobin levels in the prefrontal cortex were collected using the Functional Near-Infrared Spectroscopy (fNIRS) imaging system. Performance scores, DASS scores, and fNIRS data were subsequently analyzed to determine any correlation between performance and cortex activity. The simulator performance scores and the DASS The analysis of cognitive workload changes during simulation-based arthroscopy training revealed a significant correlation between the trainees' DASS scores and fNIRS data. This correlation suggests the potential use of fNIRS data and DASS scores as additional metrics to create adaptive training protocols for each participant. By incorporating these metrics, the training process can be optimized, leading to more efficient arthroscopic training and better preparedness for clinical operations. III.
Identifiants
pubmed: 37743389
doi: 10.1007/s00167-023-07571-0
pii: 10.1007/s00167-023-07571-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5332-5345Informations de copyright
© 2023. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
Références
Aksoy E, Izzetoglu K, Baysoy E, Agrali A, Kitapcioglu D, Onaral B (2019) Performance monitoring via functional near infrared spectroscopy for virtual reality based basic life support training. Front Neurosci 13:1336. https://doi.org/10.3389/fnins.2019.01336
doi: 10.3389/fnins.2019.01336
pubmed: 31920503
pmcid: 6920174
Aksoy E, Izzetoglu K, Onaral B, Kitapcioglu D, Sayali ME, Guven F (2019) Assessing correlation between virtual reality based serious gaming performance and cognitive workload changes via functional near infrared spectroscopy. In: Schmorrow DD, Fidopiastis CM (eds) Augmented Cognition. Springer International Publishing, Cham, pp 375–383
doi: 10.1007/978-3-030-22419-6_26
Aksoy ME, Izzetoglu K, Agrali A, Kitapcioglu D, Gungor M, Simsek A (2020) Effect of robotic surgery simulators in training assessed by functional near-infrared spectroscopy (fNIRs). In: Schmorrow DD, Fidopiastis CM (eds) Augmented Cognition Human Cognition and Behavior. Springer International Publishing, Cham, pp 271–278
doi: 10.1007/978-3-030-50439-7_18
Anetzberger H, Becker R, Eickhoff H, Seibert FJ, Döring B, Haasters F, Mohr M, Reppenhagen S (2022) The diagnostic arthroscopy skill score (DASS): a reliable and suitable assessment tool for arthroscopic skill training. Knee Surg Sports Traumatol Arthrosc 30(1):349–360
doi: 10.1007/s00167-021-06554-3
pubmed: 33914120
Anetzberger H, Reppenhagen S, Eickhoff H, Seibert FJ, Döring B, Haasters F, Mohr M, Becker R (2022) Ten hours of simulator training in arthroscopy are insufficient to reach the target level based on the diagnostic arthroscopic skill score. Knee Surg Sports Traumatol Arthrosc 30(4):1471–1479
doi: 10.1007/s00167-021-06648-y
pubmed: 34189609
Ayaz H, Shewokis PA, Bunce S, Izzetoglu K, Willems B, Onaral B (2012) Optical brain monitoring for operator training and mental workload assessment. Neuroimage 59(1):36–47
doi: 10.1016/j.neuroimage.2011.06.023
pubmed: 21722738
Baker WB, Parthasarathy AB, Busch DR, Mesquita RC, Greenberg JH, Yodh AG (2014) Modified beer-lambert law for blood flow. Biomed Opt Express 5(11):4053. https://doi.org/10.1364/BOE.5.004053
doi: 10.1364/BOE.5.004053
pubmed: 25426330
pmcid: 4242038
Bates D, Mächler M, Bolker B, Walker S (2015) fitting linear mixed-effects models using lme4. J Stat Soft. https://doi.org/10.18637/jss.v067.i01
doi: 10.18637/jss.v067.i01
Bunce SC, Izzetoglu M, Izzetoglu K, Onaral B, Pourrezaei K (2006) Functional near-infrared spectroscopy. IEEE Eng Med Biol Mag 25(4):54–62
doi: 10.1109/MEMB.2006.1657788
pubmed: 16898659
Cui X, Bray S, Bryant DM, Glover GH, Reiss AL (2011) A quantitative comparison of NIRS and fMRI across multiple cognitive tasks. Neuroimage 54(4):2808–2821
doi: 10.1016/j.neuroimage.2010.10.069
pubmed: 21047559
Cychosz CC, Tofte JN, Johnson A, Gao Y, Phisitkul P (2018) Fundamentals of arthroscopic surgery training program improves knee arthroscopy simulator performance in arthroscopic trainees. Arthroscopy 34(5):1543–1549
doi: 10.1016/j.arthro.2017.11.028
pubmed: 29395554
Dotson MP, Gustafson ML, Tager A, Peterson LM (2018) Air medical simulation training: a retrospective review of cost and effectiveness. Air Med J 37(2):131–137
doi: 10.1016/j.amj.2017.11.012
pubmed: 29478579
Frank RM, Wang KC, Davey A, Cotter EJ, Cole BJ, Romeo AA, Bush-Joseph CA, Bach BR, Verma NN (2018) Utility of modern arthroscopic simulator training models: a meta-analysis and updated systematic review. Arthroscopy 34(5):1650–1677
doi: 10.1016/j.arthro.2017.10.048
pubmed: 29366742
Izzetoglu K, Aksoy ME, Agrali A, Kitapcioglu D, Gungor M, Simsek A (2021) Studying brain activation during skill acquisition via robot-assisted surgery training. Brain Sci 11(7):937
doi: 10.3390/brainsci11070937
pubmed: 34356171
pmcid: 8303118
Izzetoglu K, Ayaz H, Merzagora A, Izzetoglu M, Shewokis PA, Bunce SC, Pourrezaei K, Rosen A, Onaral B (2011) The evolution of field deployable fNIR spectroscopy from bench to clinical settings. J Innov Opt Health Sci 04(03):239–250
doi: 10.1142/S1793545811001587
Izzetoglu K, Bunce S, Onaral B, Pourrezaei K, Chance B (2004) Functional optical brain imaging using near-infrared during cognitive tasks. Int J Hum Comput Interact 17(2):211–227
doi: 10.1207/s15327590ijhc1702_6
Izzetoglu K, Dale R (2019) Human performance assessment: evaluation of wearable sensors for monitoring brain activity. In: Vidulich M, Tsang P (eds) Improving aviation performance through applying engineering psychology: advances in aviation psychology, 1st edn. CRC Press, Boca Raton, pp 163–180
doi: 10.4324/9780429492181-8
James DRC, Orihuela-Espina F, Leff DR, Mylonas GP, Kwok K-W, Darzi AW, Yang G-Z (2010) Cognitive burden estimation for visuomotor learning with fNIRS. Med Image Comput Comput Assist Interv 13(Pt 3):319–326
pubmed: 20879415
Jöbsis FF (1977) Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science 198(4323):1264–1267
doi: 10.1126/science.929199
pubmed: 929199
Koehler RJ, Amsdell S, Arendt EA, Bisson LJ, Braman JP, Butler A, Cosgarea AJ, Harner CD, Garrett WE, Olson T, Warme WJ, Nicandri GT (2013) The arthroscopic surgical skill evaluation tool (ASSET). Am J Sports Med 41(6):1229–1237
doi: 10.1177/0363546513483535
pubmed: 23548808
pmcid: 4134966
Kuznetsova A, Brockhoff PB, Christensen RHB (2017) lmerTest package: tests in linear mixed effects models. J Stat Soft. https://doi.org/10.18637/jss.v082.i13
doi: 10.18637/jss.v082.i13
Liu Y, Lu S, Liu J, Zhao M, Chao Y, Kang P (2022) A characterization of brain area activation in orienteers with different map-recognition memory ability task levels-based on fNIRS evidence. Brain Sci 12(11):1561. https://doi.org/10.3390/brainsci12111561
doi: 10.3390/brainsci12111561
pubmed: 36421885
pmcid: 9688589
Mark JA, Kraft AE, Ziegler MD, Ayaz H (2022) Neuroadaptive training via fNIRS in flight simulators. Front Neuroergonomics 3:820523. https://doi.org/10.3389/fnrgo.2022.820523
doi: 10.3389/fnrgo.2022.820523
Middleton RM, Alvand A, Garfjeld Roberts P, Hargrove C, Kirby G, Rees JL (2017) Simulation-based training platforms for arthroscopy: a randomized comparison of virtual reality learning to benchtop learning. Arthroscopy 33(5):996–1003
doi: 10.1016/j.arthro.2016.10.021
pubmed: 28073670
Nemani A, Kruger U, Cooper CA, Schwaitzberg SD, Intes X, De S (2019) Objective assessment of surgical skill transfer using non-invasive brain imaging. Surg Endosc 33(8):2485–2494
doi: 10.1007/s00464-018-6535-z
pubmed: 30334166
Obrig H, Villringer A (2003) Beyond the visible—imaging the human brain with light. J Cereb Blood Flow Metab 23(1):1–18
doi: 10.1097/01.WCB.0000043472.45775.29
pubmed: 12500086
Paas F, Tuovinen JE, Tabbers H, Van Gerven PWM (2003) Cognitive load measurement as a means to advance cognitive load theory. Educ Psychol 38(1):63–71
doi: 10.1207/S15326985EP3801_8
Palma S, Giannoudis V, Patel P, Palan J, Guy S, Pandit H, Van Duren B (2021) Patients generally may return to driving 4 weeks after hip arthroscopy and 6 weeks after knee arthroscopy: a systematic review and meta-analysis. Arthrosc Sports Med Rehabil 3(6):e2067–e2092
doi: 10.1016/j.asmr.2021.08.015
pubmed: 34977666
pmcid: 8689281
Pedowitz RA, Esch J, Snyder S (2002) Evaluation of a virtual reality simulator for arthroscopy skills development. Arthroscopy 18(6):1–6. https://doi.org/10.1053/jars.2002.33791
doi: 10.1053/jars.2002.33791
Pedowitz RA, Marsh JL (2012) Motor skills training in orthopaedic surgery: a paradigm shift toward a simulation-based educational curriculum. J Am Acad Orthop Surg 20(7):407–409
doi: 10.5435/JAAOS-20-07-407
pubmed: 22751159
Kerr J, Molloy C, Reddy P, Shewokis PA, Izzetoglu K (2021) Individual differences in fNIRS measures of cognitive workload during a UAS mission. In: Schmorrow D, Fidopiastis C (eds) Augmented Cognition. HCII 2021. Lecture Notes in Computer Science, vol. 12776. Springer, Cham, pp. 49–62. https://doi.org/10.1007/978-3-030-78114-9_4
Reddy P, Shewokis PA, Izzetoglu K (2022) Individual differences in skill acquisition and transfer assessed by dual task training performance and brain activity. Brain Inf 9(1):9. https://doi.org/10.1186/s40708-022-00157-5
doi: 10.1186/s40708-022-00157-5
Robertson EM, Tormos JM, Maeda F, Pascual-Leone A (2001) The role of the dorsolateral prefrontal cortex during sequence learning is specific for spatial information. Cereb Cortex 11(7):628–635
doi: 10.1093/cercor/11.7.628
pubmed: 11415965
Rolfe P (2000) In vivo near-infrared spectroscopy. Annu Rev Biomed Eng 2(1):715–754
doi: 10.1146/annurev.bioeng.2.1.715
pubmed: 11701529
Ryall T, Judd BK, Gordon CJ (2016) Simulation-based assessments in health professional education: a systematic review. J Multidiscip Healthc 9:69–82
pubmed: 26955280
pmcid: 4768888
Shewokis PA, Ayaz H, Panait L, Liu Y, Syed M, Greenawald L, Shariff FU, Castellanos A, Scott Lind D (2015) Brain-in-the-loop learning using fNIR and simulated virtual reality surgical tasks: hemodynamic and behavioral effects. In: Schmorrow DD, Fidopiastis CM (eds) Foundations of Augmented Cognition. Springer International Publishing, Cham, pp 324–335
doi: 10.1007/978-3-319-20816-9_31
Singh H, Modi HN, Ranjan S, Dilley JWR, Airantzis D, Yang G-Z, Darzi A, Leff DR (2018) Robotic surgery improves technical performance and enhances prefrontal activation during high temporal demand. Ann Biomed Eng 46(10):1621–1636
doi: 10.1007/s10439-018-2049-z
pubmed: 29869104
pmcid: 6153983
Stunt JJ, Kerkhoffs GMMJ, van Dijk CN, Tuijthof GJM (2015) Validation of the ArthroS virtual reality simulator for arthroscopic skills. Knee Surg Sports Traumatol Arthrosc 23(11):3436–3442
doi: 10.1007/s00167-014-3101-7
pubmed: 25026928
Waterman BR, Martin KD, Cameron KL, Owens BD, Belmont PJ (2016) Simulation training improves surgical proficiency and safety during diagnostic shoulder arthroscopy performed by residents. Orthopedics 39(3):e479-485
doi: 10.3928/01477447-20160427-02
pubmed: 27135460
Westfall J, Kenny DA, Judd CM (2014) Statistical power and optimal design in experiments in which samples of participants respond to samples of stimuli. J Exp Psychol Gen 143(5):2020–2045
doi: 10.1037/xge0000014
pubmed: 25111580