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Extremities Feature

Source: Wikimedia Commons and Nicola Harper

New Simulation Training Improves Surgical Skills

Elizabeth Hofheinz, M.P.H., M.Ed. • Mon, December 18th, 2017

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Researchers from Chicago have found a way to improve traditional teaching methods via a program involving didactic and simulation-based education.

Their study, “Simulation-Based Educational Module Improves Intern and Medical Student Performance of Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures,” appears in the December 6, 2017 edition of The Journal of Bone and Joint Surgery.

Bennett A. Butler, M.D. a resident at the Northwestern University Feinberg School of Medicine in Chicago and co-author on the study, told OTW, “We were interested in this topic because the major goal of surgical training is to produce competent surgeons without exposing patients to undue risk. For this reason, practical, effective simulations can be invaluable. They provide training without any risk of patient harm.”

The authors wrote, “Subjects included in the study were either orthopaedic surgery interns or sub-interns at our institution. Subjects all completed a combined didactic and simulation-based course on pediatric supracondylar humeral fractures.”

“The first part of this course was an electronic (e)-learning module that the subjects could complete at home in approximately 40 minutes.”

“The second part of the course was a 20-minute simulation-based skills learning session completed in the simulation center. Subject knowledge of closed reduction and percutaneous pinning of supracondylar humeral fractures was tested using a 30-question, multiple-choice, written test. Surgical skills were tested in the operating room or in a simulated operating room. Subject pre-intervention and post-intervention scores were compared to determine if and how much they had improved.”

Dr. Butler commented to OTW, “In this case we developed a simulation course for a common pediatric procedure (pinning elbow fractures in children, otherwise known as supracondylar humerus fractures), and then proved that it was effective.”

The authors wrote, “A total of 21 subjects were tested. These subjects significantly improved their scores on both the written, multiple-choice test and skills test after completing the combined didactic and simulation module.”

“Prior to the module, intern and sub-intern multiple-choice test scores were significantly worse than postgraduate year (PGY-2)-2 to PGY-5 resident scores; after completion of the module, there was no significant difference in the multiple-choice test scores. After completing the module, there was no significant difference in skills test scores between interns and PGY-2 to PGY-5 residents….”

Dr. Butler told OTW, “This simulation, and others like it, will hopefully become a major part of both basic and advanced surgical training in the future.”

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