Is a Hands-On Simulation Model a Better Way to Teach Distal Radius Fracture Reduction and Splint Placement?
Geoffrey M. Kozak1, Shelby Nathan1; Jaclyn Mauch1; JT Lawrence1, Benjamin Chang1, Ines C Lin1
Background: Surgical residency programs are increasing the use of simulation based training to provide skill acquisition through tactile feedback while removing the stress associated with an actual patient situation. We aim to compare subject confidence and satisfaction with two learning modalities for teaching distal radius fracture (DRF) reduction.
Methods: A prospective cohort study of plastic surgery residents was conducted at our institution. Group 1 consisted of residents who attended a hands-on simulation session with initial demonstration by an attending hand surgeon followed by DRF reduction and splinting of a SAWBONES® simulator arm. Group 2 watched a series of videos on DRF reduction. All residents completed a pre- and post-training questionnaire.
Results: Seventeen residents participated in the study (Group 1, n=8; Group 2, n=9). No differences existed between groups when comparing PGY years (3.4 vs. 4.0 years, p=0.49), time on hand services (3.0 vs. 3.3 months, p=0.80), and number of prior reductions performed (5.9 vs. 7.2 reductions p=0.68). Confidence as measured in our 5-question pre-simulation survey did not show a significant difference between groups (p=0.14). The post-simulation survey results demonstrated a greater confidence score for Group 1 although not significant (84% vs. 78%, p=0.34); however, those residents felt significantly more confident in diagnosing a distal radius fracture by physical exam (p=0.023). Additionally, Group 1 reported greater learning satisfaction in every category in the 6-question survey (max score 5 – stimulating 4.6 vs. 3.3, p=0.0007; interesting 4.6 vs. 3.1, p=0.0001; learning satisfaction 4.9 vs. 3.8, p<0.0001; clarity 5 vs. 3.9, p<0.0001; effectiveness 4.9 vs. 3.6, p=0.0013; likelihood to recommend 5 vs. 3.7, p<0.0001).
Conclusion: Plastic surgery residents who performed a DRF reduction simulation reported increased confidence and had greater learning satisfaction when compared to residents who watched a video tutorial. We demonstrate that simulation based education can be an effective and stimulating model for training residents. Further investigation will examine if persistence of learning existed in both groups by assessing clinical and radiographic results of a simulated DRF reduction.
Back to 2019 Abstracts