American Council of Academic Plastic Surgeons
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Teaching the Furlow Palatoplasty Technique: a randomized, control trial comparing traditional didactic methods to a low-fidelity model
Eva Roy, BS; Erin Anstadt, MD; Pooja Humar, BS; Lisa Block, MD; Jessica Lee, MD; Joseph E Losee, MD; Jesse A Goldstein, MD
University of Pittsburgh Medical Center, Pittsburgh, PA

Background: Simulation-based teaching is increasingly utilized in medical education and has proven efficacy in building clinical and surgical skills. This study evaluates the effectiveness of using a low-fidelity model to teach medical students the technique and principles behind the Furlow Double-Opposing Z-Palatoplasty.
Methods: Medical students participating in a Plastic Surgery elective course were randomly divided into two cohorts: a control group, which received a traditional, instructor-led lecture on the Furlow palatoplasty alone, and the experimental group, which received the same lecture and participated in a low-fidelity simulation that provided hands-on instruction on the step-by-step approach to the surgical technique. The model uses a blue towel folded into two layers to represent the oral and nasal mucosal layers of the velum. Students are taught to draw relevant anatomical and surgical landmarks, perform surgical markings, and to cut out and transpose the flaps appropriately. This creates a physical demonstration of the layered palatal closure and lengthening accomplished using this technique. All students took a 10-question test evaluating their knowledge of cleft palate pathology and the Furlow Palatoplasty technique prior to the course (test 1). The control group repeated the test after the lecture, and the experimental group took the test after the lecture and simulation (test 2).
Results: 21 medical students were enrolled; 10 were randomized to the control group and 11 to the experimental group. Test 1 showed no significant difference in the mean percent of correct answers between the control and experimental groups. Following the lecture for both groups and intervention for the experimental group, there was a statistically significant difference between the two groups in the percent correct on test 2, with an average increase of 4.6% correct for the control group and 16.8% for the experimental group (p=0.046). Total materials cost per student for the simulation is $9.12.
Conclusions: This study describes a low-fidelity Furlow Palatoplasty model that significantly increased medical student understanding of the principles and procedural steps involved in this complex surgical technique. It is an inexpensive, effective educational tool that could be applied to the education of first-year Plastic Surgery residents as well.

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