High-Fidelity Wrist Fracture Phantom as a Training Tool to Develop Competency in Orthopaedic Surgical Trainees. (May 2021)

• Record Type: Journal Article
• Authors: Raeker-Jordan, Elisha A.; Martinez, Miguel; Aziz, Keith T.; Miles, Megan R.; Means, Kenneth R.; LaPorte, Dawn M.; Giladi, Aviram M.; Shimada, Kenji
• Is Part Of: Journal of the AAOS. Volume 5:Number 5(2021)
• Publication Date: 2021-05
• Subjects: Orthopedic surgery -- Periodicals; 617.4705
• DOI: 10.5435/JAAOSGlobal-D-20-00224
• Languages: English
• ISSNs: 2474-7661

Abstract

Abstract : Background: This article will describe the development of a low-cost 3D-printed medical phantom of the arm with a distal radius fracture (DRF) to facilitate training of reduction and splinting techniques. The phantom incorporates tactile responses and visual stimuli from fluoroscopy to assist skill acquisition in a clinical setting. This provides feedback to trainees to help them develop competency and knowledge before providing care to patients. Methods: Phantoms were developed through advice and feedback from fellowship-trained hand surgeons and orthopaedic senior and junior residents. Phantoms were then pilot tested during a surgical skills examination, with residents having minimal previous exposure to distal radial reduction techniques. Residents were evaluated on procedure speed and accuracy by attending surgeons using the objective structured assessment of technical skills. Residents then completed a written knowledge examination about relevant requirements of DRF management and feedback on their opinion of the exercise using the Likert scale. Results: Residents who passed the hands-on examination also scored higher on the written examination. All residents reported that the phantom was beneficial and motivating as part of their overall training. Discussion: Real-time feedback using a phantom limb and fluoroscopic imaging, in conjunction with guidance from surgeons, allows residents to learn and practice DRF reduction and splinting techniques. These educational exercises are relatively low-cost and remove the risk of potential harm to patients during early skill acquisition. This training method may be a predictor of surgical performance in addition to providing assessment of background knowledge. Additional training sessions will be required to determine the effect of repeat exposure to residents' proficiency and comprehension.