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Construct Validation of a Novel Hip Fracture Fixation Surgical Simulator

Christian, Matthew William MD; Griffith, Cullen MD; Schoonover, Carrie BS; Zerhusen, Tim Jr BS; Coale, Max BA; O'Hara, Nathan MHA; Henn, Ralph Frank III MD; O'Toole, Robert V. MD, MSME; Sciadini, Marcus MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: October 1, 2018 - Volume 26 - Issue 19 - p 689-697
doi: 10.5435/JAAOS-D-16-00724
Research Article

Introduction: A surgical simulation platform has been developed to simulate fluoroscopically guided surgical procedures by coupling computer modeling with a force-feedback device as a training tool for orthopaedic resident education in an effort to enhance motor skills and potentially minimize radiation exposure. The objective of this study was to determine whether the simulation platform can distinguish between novice and experienced practitioners of percutaneous pinning of hip fractures.

Methods: Medical students, orthopaedic residents, orthopaedic trauma fellows, and attending surgeons completed in situ hip-pinning simulation that recorded performance measures related to surgical accuracy, time, and use of fluoroscopy. Linear regression models were used to compare the association between performance and practitioner experience.

Results: Notable associations were shown between performance and practitioner experience in 10 of the 15 overall measures (P < 0.05) and 9 of 11 surgical accuracy parameters (P < 0.05).

Conclusion: This novel simulation platform can distinguish between novice and experienced practitioners and defines a performance curve for completion of simulated in situ hip pinning. This important first step lays the groundwork for subsequent validation studies, which will seek to demonstrate the efficacy of this simulator in improving clinical performance by trainees completing a sequence of skills-training modules.

From the Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

Correspondence to Dr. Sciadini: msciadini@umoa.umm.edu

Dr. Christian or an immediate family member serves as a board member, owner, officer, or committee member of the American Orthopaedic Foot and Ankle Society and the Maryland Orthopaedic Association. Dr. O'Toole or an immediate family member has received royalties from Coorstek; serves as a paid consultant to Coorstek, Imagen, and Smith & Nephew; has stock or stock options held in Imagen; has received research or institutional support from DePuy Synthes and Stryker; and serves as a board member, owner, officer, or committee member of the Orthopaedic Trauma Association. Dr. Sciadini or an immediate family member serves as a paid consultant to and has stock or stock options held in Stryker. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Griffith, Ms. Schoonover, Mr. Zerhusen, Mr. Coale, Mr. O'Hara, and Dr. Henn.

Copyright 2018 by the American Academy of Orthopaedic Surgeons.
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