Home / Evidence
Every outcome claim on this site links here. This is where the publications live — with their DOI — alongside the examination regulations and assessment tools. What we cannot support, we do not write.
The finding that started everything
“The number of arthroscopies performed by a trainee does not allow conclusions to be drawn about their level of skill.”
ANETZBERGER, KUGLER, JOHN, KOPF, BECKER, REPPENHAGEN · KNEE SURG SPORTS TRAUMATOL ARTHROSC, 2023 · DOI 10.1007/s00167-023-07471-3
If operative volume does not prove competence, something is needed that measures it. That is precisely the rationale for purchasing a simulator — not convenience, but the absence of any other objective measure.
How to read the list
The ordering follows the manufacturer’s classification. Weight increases from bottom to top: that the device looks convincing is the weakest claim; that training on it changes performance in the operating theatre — the strongest.
I
Face validity
Whether the device looks and feels realistic according to practising specialists.
II
Construct validity
Whether measured metrics distinguish the expert from the novice. Without this, no examination is possible.
III
Training effect
Whether trainees objectively improve — including in randomised controlled trials.
IV
Comparative studies
How the platform performs against other simulators on the market.
I & II · FACE AND CONSTRUCT
2014
Evaluation of a passive haptic feedback simulator for knee arthroscopy.
The first study on the platform — it lays the foundation for everything that follows.
Fucentese, Rahm, Wieser,
Spillmann, Harders, Koch
KSSTA 23(4) 1077–1085
DOI 10.1007/s00167-014-2888-6
2015
Validation of ArthroS as a simulator for arthroscopic skills.
Stunt, Kerkhoffs,
van Dijk, Tuijthof
KSSTA 23(11) 3436–3442
DOI 10.1007/s00167-014-3101-7
2016
Validation of a shoulder arthroscopy simulator.
Rahm, Germann, Hingsammer,
Wieser, Gerber
KSSTA 24(5) 1730–1737
DOI 10.1007/s00167-016-4022-4
2017
Validation of the updated ArthroS: face and construct validity with new performance metrics.
Roberts, Guyver, Baldwin,
Akhtar, Alvand, Price, Rees
KSSTA 25:616
DOI 10.1007/s00167-016-4114-1
2018
Validation of the hip arthroscopy module.
Arthroscopy
DOI 10.1016/
j.arthro.2018.10.131
2021
Validation of the simulator in identifying experienced surgeons.
Tests the reverse direction: can the device detect who is already competent.
Tronchot, Berthelemy,
Thomazeau, Huaulmé, Walbron
OTSR 107:103079
2021
Head-to-head comparison with a competing platform: which is closer to reality?
The competitor's active haptics did not reach the face validity threshold (7.0) on any metric. ArthroS passive haptics exceed it across the board — overall appearance 8.42, intra-articular view 7.65, instruments 7.21 — and is significantly more realistic (p < 0.001) on all measures.
Vaghela, Trockels,
Carobene · J Clin Orthop
Trauma 16 (2021) 249–256
DOI 10.1016/j.jcot.2021.02.014
2022
Is the FAST programme a valid platform for training and examining residents?
Examines the core exercise programme, independent of joint.
Vaghela, Trockels, Lee,
Akhtar · Clin Orthop Relat
Res 480 (2022) 807–815
DOI 10.1097/CORR.0000000000002064
III · THE STRONGEST TYPE OF EVIDENCE
2021
Module-based simulator training for the knee improves technical skills in novices — randomised controlled trial.
The only randomised trial in the list. Compares module-based training, traditional training and a control group.
Beaudoin, Larrivée, McRae,
Leiter, Stranges
Arthroscopy
2021
Ten hours of arthroscopy simulator training are not sufficient to reach the target DASS level.
The argument against the one-off course — and in favour of an in-house device.
Anetzberger, Reppenhagen,
Eickhoff, Seibert, Döring,
Haasters, Mohr, Becker
KSSTA · DOI 10.1007/
s00167-021-06648-y
2020
The simulator improves acquisition of basic arthroscopic skills in first-year residents.
Walbron, Common, Thomazeau,
Hosseini, Peduzzi, Bulaid,
Sirveaux · OTSR
DOI 10.1016/j.otsr.2020.03.009
2018
Standardised simulator training improves motor skills for both knee and shoulder.
Rahm, Wieser, Bauer, Waibel,
Meyer, Gerber, Fucentese
BMC Musculoskelet Disord
DOI 10.1186/s12891-018-2072-0
2018
The FAST programme improves performance on the knee arthroscopy simulator.
Cychosz, Tofte, Johnson,
Gao, Phisitkul · Arthroscopy
34(5) 1543–1549
DOI 10.1016/j.arthro.2017.11.028
2018
Simulator effectiveness in residents according to training year.
18 orthopaedic residents; improvement in both knee and shoulder, regardless of training year.
Yari, Jandhyala, Sharareh,
Athiviraham, Shybut
Orthop J Sports Med
DOI 10.1177/2325967118810176
2016
Performance of medical students on a knee arthroscopy simulator.
Rahm, Wieser, Wicki,
Holenstein, Fucentese, Gerber
BMC Surgery
DOI 10.1186/s12893-016-0129-2
HOW IT IS MEASURED
It is not the device that determines competence — the scale does. These three are established in the literature and embedded in the platforms.
2021
DASS — Diagnostic Arthroscopy Skill Score: a reliable and appropriate tool for assessing arthroscopic training.
Developed by ten AGA instructors. Passing the examination is mandatory for the title “AGA Certified Surgeon”.
Anetzberger, Becker, Eickhoff,
Seibert, Döring, Haasters,
Mohr, Reppenhagen · KSSTA
DOI 10.1007/s00167-021-06554-3
2016
Which global rating scale? A comparison of ASSET, BAKSSS and IGARS.
Compares the three established scales for rating arthroscopic performance.
Journal of Bone and
Joint Surgery
DOI 10.2106/JBJS.O.00434
2022
Simulation training should become a mandatory component of orthopaedic education.
Survey of 557 residents: 100 % consider simulation training important, 84 % want it mandatory in the curriculum. The position paper from which the AGA and Swiss Orthopaedics regulations derive.
Seil, Hoeltgen, Thomazeau,
Anetzberger, Becker
J Exp Orthop 9:22
Now mandatory
Four professional societies have already taken this step. When a committee asks you why a simulator, this is the answer.
2013
Swiss Orthopaedics
Part of the specialty board examination.
2018
AANA
Partnership and courses at the Orthopedic Learning Center, Rosemont.
2023
AGA
Mandatory DASS examination for the title “AGA Certified Surgeon”.
2023
ESSKA
First simulator course in January.
RESEARCH DEPTH BY AREA
The most extensively researched specialty — including one randomised controlled trial and a dedicated examination scale.
Urology 4 STUDIESTURP, TURBT and laser enucleation — including assessment of educational value within a training programme.
Gynaecology 3 STUDIESHysteroscopy and ultrasound simulation training in university teaching practice.
The full lists are on the individual device pages. Source of the selection: the literature review and VirtaMed technical data sheets.
We prepare a dossier with the full texts and a rationale tailored to your programme.
