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Int J Comput Assist Radiol Surg. 2018 Feb;13(2):305-319. doi: 10.1007/s11548-017-1688-0. Epub 2017 Dec 8.

An advanced simulator for orthopedic surgical training.

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Center for Cyber Physical Systems, Computer Science, Oklahoma State University, Stillwater, OK, 74078, USA.
Center for Cyber Physical Systems, Computer Science, Oklahoma State University, Stillwater, OK, 74078, USA.
Orthopaedic Surgery, Paul Foster School of Medicine, Texas Tech Health Sciences Center (TTHSC), El Paso, TX, USA.



The purpose of creating the virtual reality (VR) simulator is to facilitate and supplement the training opportunities provided to orthopedic residents. The use of VR simulators has increased rapidly in the field of medical surgery for training purposes. This paper discusses the creation of the virtual surgical environment (VSE) for training residents in an orthopedic surgical process called less invasive stabilization system (LISS) surgery which is used to address fractures of the femur.


The overall methodology included first obtaining an understanding of the LISS plating process through interactions with expert orthopedic surgeons and developing the information centric models. The information centric models provided a structured basis to design and build the simulator. Subsequently, the haptic-based simulator was built. Finally, the learning assessments were conducted in a medical school.


The results from the learning assessments confirm the effectiveness of the VSE for teaching medical residents and students. The scope of the assessment was to ensure (1) the correctness and (2) the usefulness of the VSE. Out of 37 residents/students who participated in the test, 32 showed improvements in their understanding of the LISS plating surgical process. A majority of participants were satisfied with the use of teaching Avatars and haptic technology. A paired t test was conducted to test the statistical significance of the assessment data which showed that the data were statistically significant.


This paper demonstrates the usefulness of adopting information centric modeling approach in the design and development of the simulator. The assessment results underscore the potential of using VR-based simulators in medical education especially in orthopedic surgery.


LISS plating; Orthopedic simulator; Surgery; Virtual reality (VR)

[Indexed for MEDLINE]

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