Gregory Lopez1, Rick Wright2, David Martin3, James Jung4, Daniel Bracey3, Ranjan Gupta4. 1. Department of Orthopaedic Surgery, University of California, Irvine, 101 The City Drive, Orange, CA 92868. 2. Department of Orthopaedic Surgery, Washington University, 660 South Euclid Avenue, Campus Box 8233, St. Louis, MO 63110. 3. Department of Orthopaedic Surgery, Wake Forest School of Medicine, 131 Miller Street, Winston-Salem, NC 27103. 4. Departments of Orthopaedic Surgery (J.J. and R.G.), Biomedical Engineering (R.G.), and Anatomy and Neurobiology (R.G.), Neuroscience Research Facility, University of California, Irvine, 2226 Gillespie Neuroscience Research Facility, Irvine, CA 92697. E-mail address for R. Gupta: ranjang@uci.edu.
Abstract
BACKGROUND: Psychomotor testing has been recently incorporated into residency training programs not only to objectively assess a surgeon's abilities but also to address current patient-safety advocacy and medicolegal trends. The purpose of this study was to develop and test a cost-effective psychomotor training and assessment tool-The Fundamentals of Orthopaedic Surgery (FORS)-for junior-level orthopaedic surgery resident education. METHODS: An orthopaedic skills board was made from supplies purchased at a local hardware store with a total cost of less than $350 so as to assess six different psychomotor skills. The six skills included fracture reduction, three-dimensional drill accuracy, simulated fluoroscopy-guided drill accuracy, depth-of-plunge minimization, drill-by-feel accuracy, and suture speed and quality. Medical students, residents, and attending physicians from three orthopaedic surgery residency programs accredited by the Accreditation Council for Graduate Medical Education participated in the study. Twenty-five medical students were retained for longitudinal training and testing for four weeks. Each training session involved an initial examination followed by thirty minutes of board training. The time to perform each task was measured with accuracy measurements for the appropriate tasks. Statistical analysis was done with one-way analysis of variance, with significance set at p < 0.05. RESULTS: Forty-seven medical students, twenty-nine attending physicians, and fifty-eight orthopaedic surgery residents participated in the study. Stratification among medical students, junior residents, and senior residents and/or attending physicians was found in all tasks. The twenty-five medical students who were retained for longitudinal training improved significantly above junior resident level in four of the six tasks. CONCLUSIONS: The FORS is an effective simulator of basic motor skills that translates across a wide variety of operations and has the potential to advance junior-level participants to senior resident skill level. CLINICAL RELEVANCE: The FORS simulator may serve as a valuable tool for resident education.
BACKGROUND: Psychomotor testing has been recently incorporated into residency training programs not only to objectively assess a surgeon's abilities but also to address current patient-safety advocacy and medicolegal trends. The purpose of this study was to develop and test a cost-effective psychomotor training and assessment tool-The Fundamentals of Orthopaedic Surgery (FORS)-for junior-level orthopaedic surgery resident education. METHODS: An orthopaedic skills board was made from supplies purchased at a local hardware store with a total cost of less than $350 so as to assess six different psychomotor skills. The six skills included fracture reduction, three-dimensional drill accuracy, simulated fluoroscopy-guided drill accuracy, depth-of-plunge minimization, drill-by-feel accuracy, and suture speed and quality. Medical students, residents, and attending physicians from three orthopaedic surgery residency programs accredited by the Accreditation Council for Graduate Medical Education participated in the study. Twenty-five medical students were retained for longitudinal training and testing for four weeks. Each training session involved an initial examination followed by thirty minutes of board training. The time to perform each task was measured with accuracy measurements for the appropriate tasks. Statistical analysis was done with one-way analysis of variance, with significance set at p < 0.05. RESULTS: Forty-seven medical students, twenty-nine attending physicians, and fifty-eight orthopaedic surgery residents participated in the study. Stratification among medical students, junior residents, and senior residents and/or attending physicians was found in all tasks. The twenty-five medical students who were retained for longitudinal training improved significantly above junior resident level in four of the six tasks. CONCLUSIONS: The FORS is an effective simulator of basic motor skills that translates across a wide variety of operations and has the potential to advance junior-level participants to senior resident skill level. CLINICAL RELEVANCE: The FORS simulator may serve as a valuable tool for resident education.
Authors: Jeffrey J Olson; Bo Zhang; Diana Zhu; Evan T Zheng; George S M Dyer; Tamara D Rozental; Dawn M LaPorte Journal: JB JS Open Access Date: 2021-02-19