Validity Assessment of a Three-Dimensional Printed Arthroscopic Shoulder Simulator: An Experimental Evaluation of Construct Validity and Educational Value.

INTRODUCTION: To solve barriers to simulation-based training of residents, we have developed a three-dimensional (3D) printed anatomic shoulder simulator that is low cost and deployable worldwide. The purpose of our study was to evaluate the educational and construct validity of a novel 3D-printed shoulder simulator (3DP) for arthroscopy of the shoulder and compare it to a commercially available shoulder simulator (control). METHODS: In this institutional review board-approved randomized controlled trial, 20 participants were divided into four groups: five senior medical students and five expert surgeons for each simulator. Participants completed four arthroscopic tasks, which were videorecorded and assessed using the Arthroscopic Surgery Skill Evaluation Tool (ASSET) and time to task completion. Pre- and posttask anatomy tests were also administered. RESULTS: The expert surgeon group was faster to complete arthroscopic tasks than the medical student group for both the control (P = 0.003) and 3DP (P = 0.046). The ASSET scores were markedly higher for expert surgeons versus medical students on the 3DP (P = 0.017), with no difference on the control (P = 0.533). After task completion, medical students improved scores on an anatomy test from an average of 52% to a 76% on the control and from 52% to 84% on the 3DP. CONCLUSION: The 3D printed arthroscopic shoulder simulator demonstrated construct validity based on time and ASSET scores, while also demonstrating educational value. The commercially available shoulder simulator demonstrated construct validity based on time; however, it was not able to differentiate skill level based on arthroscopic skills assessment.