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General Orthopaedics

A NOVEL AND FEASIBLE APPROACH TO CONTEXTUALISED ORTHOPAEDIC SIMULATION TRAINING

British Orthopaedic Trainee Association Annual General Meeting (BOTA)



Abstract

Introduction

Current work-hour restrictions and cost pressures have highlighted the limitations of apprenticeship-based learning, and led to the development of alternative methods to improve the skills of orthopaedic trainees outside of the clinical environment. These methods include using synthetic bones and simulators in the laboratory setting. Educational theory highlights the importance of context for effective learning, yet full-immersion simulation facilities are prohibitively expensive. This study explored the concept of contextualised training day in trauma & orthopaedics.

Methods

Fifteen novice surgeons provided feedback after completing three teaching modules:

  1. 1)

    OSCE-style Problem-based Learning of Orthopaedic Trauma in the Fracture Clinic Setting, utilising an actor and radiographs to teach history, examination, diagnostic and management skills

  2. 2)

    The positioning, preparing and draping of a patient, and Examination under anaesthesia (EUA) for arthroscopic knee surgery, utilising an operating table and theatre equipment to teach procedural and examination skills

  3. 3)

    Simulator based training for diagnostic shoulder and knee arthroscopy; and Bankart repair, utilising arthroscopic stack and synthetic joint models to develop arthroscopic motor skill and procedural knowledge

Findings

The combination of simulated patients and part-task trainers (a simulator that simulates a limited component of a clinical procedure) created a multimodal clinical context. The three novel teaching modules allowed the integration of technical and non-technical skills in low-cost and high-fidelity orthopaedic simulation environments.