Papavasiliou Theodora, Chatzimichail Stelios, Chan Jeffrey C Y, Bain Charles J, Uppal Lauren
Department of Plastic Surgery, Guys' and St. Thomas' Hospitals, Lambeth, London, UK.
Department of Surgery and Cancer, Imperial College London, White City Campus, London, UK.
Plast Reconstr Surg Glob Open. 2021 Feb 15;9(2):e3406. doi: 10.1097/GOX.0000000000003406. eCollection 2021 Feb.
Surgery for hand trauma accounts for a significant proportion of the plastic surgery training curriculum. The aim of this study was to create a standardized simulation training module for hand fracture fixation with Kirschner wire (K-wire) techniques for residents to create a standardized hand training framework that universally hones their skill and prepares them for their first encounter in a clinical setting.
A step-ladder approach training with 6 levels of difficulty on 3-dimensional (3D) printed ex vivo hand biomimetics was employed on a cohort of 20 plastic surgery residents (n = 20). Assessment of skills using a score system (global rating scale) was performed in the beginning and at the end of the module by hand experts of our unit.
The overall average scores of the cohort before and after assessment were 23.75/40 (59.4%) and 34.7/40 (86.8%), respectively. Significant ( < 0.01) difference of improvement of skills was noted on all trainees. All trainees confirmed that the simulated models provided in this module were akin to the patient scenario and noted that it helped them improve their skills with regard to K-wire fixation techniques, including improvement of their understanding of the 3D bone topography.
We demonstrate a standardized simulation training framework that employs 3D printed ex vivo hand biomimetics proved to improve the skills of residents and that paves the way to more universal, standardized and validated training across hand surgery. This is, to our knowledge, the first standardized method of simulated training on such hand surgical cases.
手部创伤手术在整形外科学培训课程中占很大比例。本研究的目的是为住院医师创建一个用于克氏针（K 线）技术手部骨折固定的标准化模拟训练模块，以创建一个通用的标准化手部训练框架，全面提升他们的技能，并让他们为首次临床实践做好准备。
对 20 名整形外科学住院医师（n = 20）采用在三维（3D）打印的离体手部仿生模型上进行六级难度的阶梯式训练方法。在模块开始和结束时，由本单位的手部专家使用评分系统（整体评分量表）对技能进行评估。
评估前后该队列的总体平均得分分别为 23.75/40（59.4%）和 34.7/40（86.8%）。所有受训者的技能提升均有显著差异（<0.01）。所有受训者均确认该模块中提供的模拟模型类似于患者场景，并指出这有助于他们提高克氏针固定技术的技能，包括增强对三维骨骼形态的理解。
我们展示了一个标准化模拟训练框架，该框架采用 3D 打印的离体手部仿生模型，证明可提高住院医师的技能，并为手部手术更通用、标准化和经过验证的培训铺平道路。据我们所知，这是此类手部手术模拟训练的首个标准化方法。
