A Hybrid Reality Radiation-Free Simulator for Teaching Wire Navigation Skills. Issue 10 (October 2015)

• Record Type: Journal Article
• Authors: Kho, Jenniefer Y.; Johns, Brian D.; Thomas, Geb W.; Karam, Matthew D.; Marsh, John L.; Anderson, Donald D.
• Is Part Of: Journal of orthopaedic trauma. Volume 29:Issue 10(2015)
• Publication Date: 2015-10
• Subjects: surgical simulation -- hip fracture -- hybrid reality; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000000372
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : 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.