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新型髋关节骨折固定手术模拟器的构建验证。

Construct Validation of a Novel Hip Fracture Fixation Surgical Simulator.

机构信息

From the Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

出版信息

J Am Acad Orthop Surg. 2018 Oct 1;26(19):689-697. doi: 10.5435/JAAOS-D-16-00724.

Abstract

INTRODUCTION

A surgical simulation platform has been developed to simulate fluoroscopically guided surgical procedures by coupling computer modeling with a force-feedback device as a training tool for orthopaedic resident education in an effort to enhance motor skills and potentially minimize radiation exposure. The objective of this study was to determine whether the simulation platform can distinguish between novice and experienced practitioners of percutaneous pinning of hip fractures.

METHODS

Medical students, orthopaedic residents, orthopaedic trauma fellows, and attending surgeons completed in situ hip-pinning simulation that recorded performance measures related to surgical accuracy, time, and use of fluoroscopy. Linear regression models were used to compare the association between performance and practitioner experience.

RESULTS

Notable associations were shown between performance and practitioner experience in 10 of the 15 overall measures (P < 0.05) and 9 of 11 surgical accuracy parameters (P < 0.05).

CONCLUSION

This novel simulation platform can distinguish between novice and experienced practitioners and defines a performance curve for completion of simulated in situ hip pinning. This important first step lays the groundwork for subsequent validation studies, which will seek to demonstrate the efficacy of this simulator in improving clinical performance by trainees completing a sequence of skills-training modules.

摘要

简介

为了提高矫形住院医师的手术技能并降低潜在的辐射暴露,我们开发了一种手术模拟平台,该平台将计算机建模与力反馈设备相结合,以模拟荧光透视引导的手术过程,作为矫形住院医师教育的培训工具。本研究旨在确定该模拟平台是否能够区分髋关节骨折经皮穿针术的新手和经验丰富的医生。

方法

医学生、矫形住院医师、矫形创伤研究员和主治医生完成了现场髋关节模拟穿针手术,记录了与手术准确性、时间和荧光透视使用相关的绩效指标。线性回归模型用于比较绩效与医生经验之间的关联。

结果

在 15 项总体指标中的 10 项(P<0.05)和 11 项手术准确性参数中的 9 项(P<0.05)中,表现与医生经验之间存在显著关联。

结论

这种新型的模拟平台可以区分新手和经验丰富的医生,并为完成模拟现场髋关节穿针术定义了一个性能曲线。这一重要的第一步为后续的验证研究奠定了基础,这些研究将寻求证明该模拟器通过完成一系列技能培训模块来提高受训者的临床绩效的功效。

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