Simulation-based arthroscopic surgery study

INTERVENTION: Participants are randomly allocated to one of two groups using a blocked randomisation with random block sizes and a 1:1 allocation ratio. Control/Non‐simulation study arm: Participants will receive no additional treatment/training beyond their usual day to day clinical work as a senior house officer level trainee (including but not limited to: ward work, attending theatre, clinics, out‐of‐hours/‘on‐call’) for the 13 weeks of the study. Intervention/simulation study arm: Participants will receive weekly 1 hour simulation sessions over 13 weeks at the skills lab at the Nuffield Orthopaedic Centre, arranged on an individual basis to fit around clinical commitments. The simulation sessions will involve self directed practice on non‐anatomical and anatomic arthroscopic bench‐top simulators (#1711‐1 and #1517‐29‐11 available from SawBones, Malmo, SE), during which they can monitor their performance using wireless elbow mounted motion sensors recording hand movements, smoothness of hand movements and time taken. Total duration is 13 weeks in both groups. Both groups will be followed up at 13 weeks, with no planned further follow up. CONDITION: Arthroscopic surgery training ; Surgery ; Arthroscopic surgery training PRIMARY OUTCOME: Motion analysis parameters ('hand movements', 'minor hand movements', 'smoothness of movements', 'time taken', 'maximum hand acceleration', 'stationary time', 'idle time' and 'hand dominance') are measured using wireless elbow mounted motion sensors during diagnostic knee arthroscopy at 3 months. SECONDARY OUTCOME: 1. Performance during diagnostic knee arthroscopy is measured using the Global rating scale at 3 months; 2. Motion analysis parameters as a function of 'ideal' motion analysis parameters are judged by a supervising clinician during the same case at 3 months; 3. Change in simulator performance using motion analysis parameters at baseline and 3 months; 4. Structural and functional changes on fMRI using resting state networks, voxel based morphometry, diffusion tractography and quantitative magnetisation transfer is measured at 3 month follow up by comparison to baseline fMRI; 5. Feasibility of simulation training during usual clinical training is measured using a qualitative survey designer for this study at 3 month follow up INCLUSION CRITERIA: 1. Participant is willing and able to give informed consent for participation in the study 2. Healthy adults, Male or Female, aged 18 years or above 3. Enrolled in Health Education Thames Valley/Oxford Deanery Training Programme in junior surgical training posts