Virtual Reality and Augmented Reality Are Uniquely Suited to Hip Arthroscopy Education and Reveal Adequate Face, Content, and Construct Validity: A Systematic Review With Expert Commentary
Bibliographic record
Abstract
PURPOSE: To (1) summarize the current literature regarding virtual reality (VR)/augmented reality (AR) as it pertains to efficacy in hip arthroscopy training, (2) compare the VR/AR performance of experienced and less experienced hip arthroscopists, and (3) assess the suitability of VR/AR for hip arthroscopy education by assessing various elements of validity. METHODS: Three databases were searched on February 9, 2025, for studies investigating VR/AR simulation in hip arthroscopy training. Descriptive statistics were used to report participant details, simulation specifics, and validity (e.g., face, construct, and content). RESULTS: Nine studies comprising 218 participants were included, 37 (16.9%) being considered experienced. Most studies (7 of 9, 77.8%) were analyses of 1 session, with 2 studies comparing progress during sessions over time. Five studies investigated face validity; the majority of participants (>70%) in each of these studies found that simulators were realistic in all elements apart from tactile feedback. Eight studies evaluated construct validity. Three of four studies (75%) found statistically lower amounts of iatrogenic tissue damage in the experienced group (P ≤ .002). Three of four studies (75%) found that the experienced group had shorter completion times (P ≤ .03) than the non-experienced group. One study reported lower iatrogenic damage (P < .0001) and completion times (P < .001) with repeated sessions in non-experienced learners. CONCLUSIONS: VR/AR simulation training for hip arthroscopy reveals good face, content, and construct validity. Generally, VR/AR simulations were rated by users as realistic in most elements apart from tactile feel. Participants, particularly junior learners, improved in minimizing iatrogenic tissue damage, decreasing completion time, and minimizing excess travel with the scope. More experienced hip arthroscopists generally outperformed non-experienced participants in the majority of performance metrics and scores. LEVEL OF EVIDENCE: Level IV, systematic review of Level I, II, and IV studies, plus Level V, expert opinion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.173 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.006 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.005 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".