Subjective assessment of hand-eye coordination and manual dexterity does not accurately predict performance on a virtual reality shoulder arthroscopy simulator

Maulik J. Gandhi1, M.J. Anderton2, L. Funk3

1 Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, UK.
2 North West Deanery, England, UK
3 HCA Hospitals, Wrightington Hospital & University of Salford, UK

BORS & SECEC, 2015

Background: Orthopaedic training programmes are amongst the most popular specialties for junior doctors. Traditional selection processes involves the use of curriculum vitae, standardised application forms and interview stations. There are also an increasing number of clinical and practical scenarios. Very few scenarios have been reported that include an aptitude for arthroscopic skills. The arthroscopic skill set is very different to open surgery. The goal of this study was to investigate whether simple subjective measures of hand-eye coordination and manual dexterity (which may be the basis of a selection process) correlate with performance on a validated virtual shoulder arthroscopy simulator (Insight Arthro VR).

Methods: Sixty-five participants subjectively assessed their hand-eye coordination and manual dexterity using a numerical scale 1-5 (1 = below average, 3 = average, 5= above average). They performed four tasks (“operating room”, “visualize”, “locate and palpate”, and “pendulum”) on the VR simulator. Correlations were assessed between (1) hand-eye coordination scores, (2) manual dexterity scores, and 15 VR measures using Pearson’s correlation coefficients.

Results: The operating room time correlated with manual dexterity score (r=-.454, p=0.0001) and hand-eye coordination score (r=-0.336, p=0.006) suggesting an above average subjective score resulted in a shorter performance time in the operating room VR task. The remaining correlations between the subjective scores and VR performance did not reach significance.

Conclusions: Operating room VR task is a single-handed orientation task, rather than procedural tasks encountered in shoulder arthroscopy. The lack of correlation between the subjective scores and common procedural tasks suggest methods of assessment of arthroscopic performance should not be subjective based.

Table 1: ArthroVR tasks & parameters recorded

Table 2: Correlation between subjective assessment of manual dexterity and hand-eye co-ordination and ArthroVR tasks performance


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