期刊
JOURNAL OF ORTHOPAEDIC TRAUMA
卷 29, 期 10, 页码 e385-e390出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOT.0000000000000372
关键词
surgical simulation; hip fracture; hybrid reality
资金
- National Board of Medical Examiners (NBME) Edward J. Stemmler, MD, Medical Education Research Fund grant
- Orthopaedic Research and Education Foundation
- OMeGA Medical Grants
- Orthopaedic Trauma Association
- Agency for Healthcare Research and Quality [R18HS022077]
Objectives:Surgical simulation is an increasingly important method to facilitate the acquiring of surgical skills. Simulation can be helpful in developing hip fracture fixation skills because it is a common procedure for which performance can be objectively assessed [ie, the tip-apex distance (TAD)]. The procedure requires fluoroscopic guidance to drill a wire along an osseous trajectory to a precise position within bone. The objective of this study was to assess the construct validity for a novel radiation-free simulator designed to teach wire navigation skills in hip fracture fixation.Methods:Novices (n = 30) with limited to no surgical experience in hip fracture fixation and experienced surgeons (n = 10) participated. Participants drilled a guide wire in the center-center position of a synthetic femoral head in a hip fracture simulator, using electromagnetic sensors to track the guide-wire position. Sensor data were gathered to generate fluoroscopic-like images of the hip and guide wire. Simulator performance of novice and experienced participants was compared to measure construct validity.Results:The simulator was able to discriminate the accuracy in guide-wire position between novices and experienced surgeons. Experienced surgeons achieved a more accurate TAD than novices (13 vs. 23 mm, respectively, P = 0.009). The magnitude of improvement on successive simulator attempts was dependent on the level of expertise; TAD improved significantly in the novice group, whereas it was unchanged in the experienced group.Conclusions:This hybrid reality, radiation-free hip fracture simulator, which combines real-world objects with computer-generated imagery, demonstrates construct validity by distinguishing the performance of novices and experienced surgeons. There is a differential effect depending on the level of experience, and it could be used as an effective training tool in novice surgeons.
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