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General Orthopaedics

INDEPENDENT LEARNING VERSUS MENTORSHIP WITH THE INTRODUCTION OF NEW SURGICAL SKILLS: A PILOT STUDY

Canadian Orthopaedic Association (COA) and Canadian Orthopaedic Research Society (CORS) Annual Meeting, June 2016; PART 1.



Abstract

With the rapid evolution of surgical techniques every practicing surgeon will need to introduce new skills into their practice. Despite evidence that introducing a new surgical technique is associated with a learning curve during which there are reduced surgical and patient outcomes, there are no suggested protocols in place to support a surgeon in safely introducing a procedure into established practice. The purpose of this pilot study was to compare the effects of a mentored approach to learning new technical skills in practice to an unmentored approach.

A mentorship partnership and learning protocol was developed between a learning surgeon and an expert in the Direct Anterior Approach (DAA) total hip arthroplasty. After training in the technique the learning surgeon was directly supported in the first 3 cases and mentored for the first 15 cases.

Outcomes (surgical times, estimated blood loss, canal fit and fill, acetabular inclination and version, and complications) for the learning surgeons first 30 cases were assessed and compared to another learned cohort (first 30 cases of a percutaneously assisted total hip arthroplasty) integrated into practice without the support of a mentor. This data allow for the comparison of learning curves between the 2 techniques

Use of a mentored approach to the introduction of a new surgical skill was demonstrated to be a safe and more efficient than with an independent introduction of skills. The surgical times and learning curve were reduced and anectodatly the surgeons stress level was markedly reduced with a mentored approach. These findings support further work into surgical mentorship for the safe introduction of surgical skills in practice.


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