Department of Hand and Reconstructive Microsurgery, National University Health Systems, Singapore.
Training Center for Experimental Surgery, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
J Hand Surg Asian Pac Vol. 2024 Jun;29(3):171-178. doi: 10.1142/S2424835524500176. Epub 2024 May 10.
Simulation models enable learners to have repeated practise at their own time, to master the psycho-motor and sensory acuity aspects of surgery and build their confidence in the procedure. The study aims to develop and evaluate the feasibility of a low-cost drilling model to train surgeons in the drilling task. The model targets three aspects of drilling - (1) Reduce plunge depth, (2) Ability to differentiate between bone and medullary canal and (3) Increase accuracy drilling in various angles. This cross-sectional study was conducted after obtaining ethics approval. We invited Consultants in the field of Orthopaedic or Hand Surgery to form the 'expert' group, and the 'novice' group consisted of participants who had no prior experience in bone drilling. We developed a drilling simulator model made from a polyvinyl chloride (PVC) pipe filled with liquid silicone. This model cost less than US$5. An electric Bosch drill (model GBM 10 RE) with a 1.4 mm K-wire 10 cm in length (6.5 cm outside the drill) was used for drilling. The main outcomes of the study were time taken for drilling, plunge depth, ability to penetrate the far cortex and accuracy. Thirty-one participants were recruited into the study, of which 15 were experts and 16 were novices. The experts performed significantly better for plunge depth ( = -3.65, = 0.0003) and accuracy ( = -2.07, = 0.04). The experts required 20% less time to complete the drilling tasks, but it was not statistically significant ( = -0.79, = 0.43). The low-cost drilling model could be useful in training Residents in the drilling task. It will allow Residents to practise independently at their own time and assess their own performance.
模拟模型使学习者能够在自己的时间里反复练习，掌握手术的心理运动和感官敏锐度方面的技能，并增强他们对手术过程的信心。本研究旨在开发和评估一种低成本钻孔模型，以培训外科医生进行钻孔任务。该模型针对钻孔的三个方面：（1）减少下钻深度，（2）能够区分骨和骨髓腔，以及（3）在各种角度下提高钻孔精度。本横断面研究在获得伦理批准后进行。我们邀请骨科或手外科领域的顾问组成“专家”小组，而“新手”小组则由没有骨钻孔经验的参与者组成。我们开发了一种由聚氯乙烯（PVC）管填充液体硅制成的钻孔模拟器模型。该模型的成本低于 5 美元。我们使用带有 1.4 毫米 K 线的电动博世钻头（型号 GBM 10 RE）进行钻孔，K 线长 10 厘米（钻头外 6.5 厘米）。该研究的主要结果是钻孔时间、下钻深度、穿透远皮质的能力和准确性。共有 31 名参与者被招募到研究中，其中 15 名是专家，16 名是新手。专家在钻孔深度（=-3.65，=0.0003）和准确性（=-2.07，=0.04）方面表现明显更好。专家完成钻孔任务所需的时间减少了 20%，但这没有统计学意义（=-0.79，=0.43）。低成本钻孔模型可用于培训住院医师进行钻孔任务。它将允许住院医师在自己的时间里独立练习，并评估自己的表现。
