Thanks to the acquisition of a VirtaMed ArthroS™ simulator, private French hospital Ramsay Générale de Santé has embarked on a new direction in its teaching program. The goal? Meet the requirements of the new training model for residents and thereby enhance the quality of future surgeons.
In the fields of aviation or navigation, student pilots/captains all go through simulation training before taking control of an aircraft. In medicine, since November 2017, this is also the case. What this means is that, in the new training model for residents, simulation training is now mandatory prior to residents practicing their skills on real patients. It is within this framework that the Research and Teaching Department of Ramsay Générale de Santé has been equipped with a new device, the VirtaMed ArthroS™, a high-fidelity virtual-reality arthroscopic simulator, with modules for both the knee and shoulder. "Admittedly, teaching is more the business of university centers,” explains Stéphane Locret, Director of Research and Teaching. “But since the HPST law of 2009 (Hospital, Patients, Health, and Territories), also known as Loi Bachelot, we offer validating internships in our establishments. And under the impetus of surgeons Olivier Courage (Private Hospital of the Estuary, Le Havre) and Geoffroy Nourissat (Clinique Maussins Nollet, Paris), we have invested in the VirtaMed ArthroS™, to continue to better train residents."
The quality of the software is quite impressive, and the simulator’s realism gives the impression of an actual arthroscopic intervention. The program has three learning phases. "At first, it's a bit like a video game,” explains Stéphane Locret. “The residents perform basic movements, acquire targets, and learn spatial awareness in order to master instrument triangulation. The second phase is an anatomical-recognition phase. Residents navigate the knee as if they were performing a real arthroscopy. Using metrics, their movements within the knee are tracked to determine if they have navigated the knee successfully. It is almost a platform game, with a feedback report at the end to see if the course has been completed, in the right order, while also recording the percentage of errors, etc. Within this phase, VirtaMed has recreated knee pathologies that residents must identify in order to provide a diagnosis. The third and last phase is the therapeutic phase. Residents here encounter pathologies they must treat, such as removing a meniscus, for example. At the end, the software gives them the final results on the quality of their treatment. The software can also create incidents such as bleeding, the goal of which is to place learners in crisis situations."
The simulation experience is one that Stéphane Locret, Olivier Courage and Geoffroy Nourissat will continue to develop, and one that they have decided to open to all residents, not only those of Ramsay Générale de Santé. The objective is to contribute to the training of residents in partnership with the UHCs who are not yet in possession of this type of equipment. "For us, it is also an opportunity to highlight the quality of our operation, and to show to residents what self-employment at a private care facility is like. The reason is simple: at the end of university, self-employment and private hospitals are unknown and often suffer from a negative image", according to Stéphane Locret. The goal is to give students the whole picture so that they can make informed choices about their future career.
The main goal is to implement a pedagogical program, supported by university department heads and which, eventually, could function as an assessment for the university. As a result, so that all residents can train on the VirtaMed simulator, the team is setting up a rotation every 6 months between Paris and Le Havre. "The idea is that in thirty-five hours (about three months), the resident gains autonomy, and after validation from his supervisors, he can begin to perform arthroscopies on patients", explains Stéphane Locret.