Kapil Sugand1, Mala Mawkin2, Chinmay Gupte3. 1. MSk Lab, Imperial College London, Level 7 East, Charing Cross Hospital, Fulham, London W6 8RF, UK. Electronic address: ks704@ic.ac.uk. 2. MSk Lab, Imperial College London, Level 7 East, Charing Cross Hospital, Fulham, London W6 8RF, UK. Electronic address: mala.mawkin13@imperial.ac.uk. 3. MSk Lab, Imperial College London, Level 7 East, Charing Cross Hospital, Fulham, London W6 8RF, UK. Electronic address: c.gupte00@ic.ac.uk.
Abstract
BACKGROUND: Simulation in orthopaedic training is becoming increasingly popular and has been widely used in formal curricula. However, these resources are expensive and not easily accessible to every trainee. Other means of disseminating surgical education through virtual reality (VR) multimedia can act as useful adjunct to traditional methods of teaching. One validated VR platform is Touch Surgery, a cognitive task simulation and rehearsal app. OBJECTIVES: The primary objective of this study was to identify the training effect of Touch Surgery intramedullary femoral nailing (IFN) modules using objective performance metrics over six consecutive attempts. Secondary objectives consisted of validated multiple choice questions (MCQ) testing before the first (pre) and after the sixth (post) attempts. METHODS: 27 medical undergraduates were recruited to complete the decision-making process six consecutive times for four modules on the procedural steps of IFN. The modules consisted of (i) preparing the patient and equipment, (ii) femoral canal preparation, (iii) nail insertion and proximal locking, and (iv) distal locking and closure. Real-time objective performance metrics were obtained, stored electronically and analysed using the median and Bonett-Price 95% confidence intervals from the participants' attempts to assess training effect. Significance was calculated using the Mann-Whitney U test for independent data whilst the Wilcoxon signed ranked test was used for paired data. Significance was set as 2-tailed p-value <0.05. RESULTS: Median performance scores per attempt for all four modules demonstrated a significant improvement ranging from 58 to 115%. Scoring variability and distribution was reduced and more predictable per attempt. Logarithmic learning curves elicited strong positive correlations between the number of attempts and scoring. Mean scores for pre and post-study MCQs tests significantly improved from 83 to 94% in all modules. CONCLUSION: IFN modules on Touch Surgery app demonstrated a significant training effect with practice. Novices demonstrated cognitive competencies to ensure patient safety prior to operating. The app is an effective adjunct to traditional learning methods and has the potential for curricular implementation.
BACKGROUND: Simulation in orthopaedic training is becoming increasingly popular and has been widely used in formal curricula. However, these resources are expensive and not easily accessible to every trainee. Other means of disseminating surgical education through virtual reality (VR) multimedia can act as useful adjunct to traditional methods of teaching. One validated VR platform is Touch Surgery, a cognitive task simulation and rehearsal app. OBJECTIVES: The primary objective of this study was to identify the training effect of Touch Surgery intramedullary femoral nailing (IFN) modules using objective performance metrics over six consecutive attempts. Secondary objectives consisted of validated multiple choice questions (MCQ) testing before the first (pre) and after the sixth (post) attempts. METHODS: 27 medical undergraduates were recruited to complete the decision-making process six consecutive times for four modules on the procedural steps of IFN. The modules consisted of (i) preparing the patient and equipment, (ii) femoral canal preparation, (iii) nail insertion and proximal locking, and (iv) distal locking and closure. Real-time objective performance metrics were obtained, stored electronically and analysed using the median and Bonett-Price 95% confidence intervals from the participants' attempts to assess training effect. Significance was calculated using the Mann-Whitney U test for independent data whilst the Wilcoxon signed ranked test was used for paired data. Significance was set as 2-tailed p-value <0.05. RESULTS: Median performance scores per attempt for all four modules demonstrated a significant improvement ranging from 58 to 115%. Scoring variability and distribution was reduced and more predictable per attempt. Logarithmic learning curves elicited strong positive correlations between the number of attempts and scoring. Mean scores for pre and post-study MCQs tests significantly improved from 83 to 94% in all modules. CONCLUSION: IFN modules on Touch Surgery app demonstrated a significant training effect with practice. Novices demonstrated cognitive competencies to ensure patient safety prior to operating. The app is an effective adjunct to traditional learning methods and has the potential for curricular implementation.
Authors: Richard D Bartlett; Dina Radenkovic; Stefan Mitrasinovic; Andrew Cole; Iva Pavkovic; Peyton Cheong Phey Denn; Mahrukh Hussain; Magdalena Kogler; Natalia Koutsopodioti; Wasima Uddin; Ivan Beckley; Hana Abubakar; Deborah Gill; Daron Smith Journal: BMC Med Educ Date: 2017-12-11 Impact factor: 2.463
Authors: Patrick Haubruck; Felix Nickel; Julian Ober; Tilman Walker; Christian Bergdolt; Mirco Friedrich; Beat Peter Müller-Stich; Franziska Forchheim; Christian Fischer; Gerhard Schmidmaier; Michael C Tanner Journal: J Med Internet Res Date: 2018-05-21 Impact factor: 5.428
Authors: Jonathan D Bartlett; John E Lawrence; Matthew Yan; Borna Guevel; Max E Stewart; Emmanuel Audenaert; Vikas Khanduja Journal: Arch Orthop Trauma Surg Date: 2020-01-27 Impact factor: 3.067
Authors: José Negrillo-Cárdenas; Juan-Roberto Jiménez-Pérez; Joaquim Madeira; Francisco R Feito Journal: Int J Comput Assist Radiol Surg Date: 2021-08-07 Impact factor: 2.924