| Abstract ID |
| 20260130 |
| Category |
| Knee: ACL |
| Preferable Presentation |
| Oral Presentation |
| Title |
| A PROSPECTIVE, COMPARATIVE STUDY OF A PROFICIENCY-BASED VIRTUAL REALITY SIMULATION CURRICULUM TO TRADITIONAL TRAINING ON SURGICAL SKILL PROFICIENCY, THEORETICAL KNOWLEDGE, AND RESIDENT CONFIDENCE AND ANXIETY IN ACL RECONSTRUCTION AMONG ORTHOPEDIC SURGERY RESIDENTS |
| Author |
|
| Presenter |
| Siwakorn Dansithong |
| Abstract |
| Background: Anterior Cruciate Ligament (ACL) reconstruction is a technically demanding orthopedic procedure with a steep learning curve, where surgical precision is paramount to preventing complications. A virtual reality (VR) simulation has the potential to shorten the learning process, allowing trainees to overcome the initial steep part of the learning curve before entering the operating theater Objective: To evaluate the efficacy of a proficiency-based VR simulation curriculum compared to traditional training on surgical skill proficiency, theoretical knowledge, procedural confidence, and state anxiety among orthopedic residents performing anterior cruciate ligament (ACL) reconstruction. Study design: A prospective, single-centre, single-blinded, comparative study was conducted. Thirty-three orthopedic surgery residents (Post-Graduate Years 1-4) were prospectively enrolled and assigned to either an intervention group receiving a proficiency-based VR curriculum (n=17) or a control group receiving traditional multimodal training (n=16). The primary outcome was surgical skill proficiency on a fresh-frozen cadaveric model, assessed using the Arthroscopic Surgical Skill Evaluation Tool (ASSET) and an ACL Reconstruction-Specific Checklist. Secondary outcomes included theoretical knowledge (30-item multiple-choice question examination), procedural confidence (5-point Likert scale), and state anxiety (State-Trait Anxiety Inventory [STAI] Form Y-1). Data were analysed using independent samples t-tests, paired t-tests, and one-way analysis of variance (ANOVA). Results: At the immediate post-intervention cadaveric assessment, the VR group demonstrated higher mean ASSET scores (21.71 ± 3.65 vs. 19.81 ± 4.12; P = .170) and ACL-Specific Checklist scores (4.65 ± 1.54 vs. 4.06 ± 1.84; P = .329) compared to the control group, though not statistically significant. Both groups significantly improved their theoretical knowledge (P < .0001), with the VR group showing a larger mean increase (+6.18 vs. +4.00 points). Procedural anxiety was significantly reduced in both groups, but the VR group experienced a reduction more than twice that of the control group (-8.65 vs. -4.00 points; P < .0001). Overall confidence increased significantly, with the VR group showing a substantially greater gain (+6.65 vs. +3.19 points; P = .085). Conclusions: While a proficiency-based VR curriculum did not demonstrate statistically significant superiority in immediate cadaveric surgical skill scores over rigorous traditional training, it proved highly effective as an educational adjunct. VR training significantly accelerates knowledge acquisition, substantially boosts procedural confidence, and is particularly effective at mitigating the universal procedural anxiety experienced by orthopedic residents. |