A Novel Approach for Assessing and Training the Drilling Skills of Orthopaedic Surgeons.
Journal
The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
Titre abrégé: J Bone Joint Surg Am
Pays: United States
ID NLM: 0014030
Informations de publication
Date de publication:
21 Aug 2019
21 Aug 2019
Historique:
entrez:
23
8
2019
pubmed:
23
8
2019
medline:
22
1
2020
Statut:
ppublish
Résumé
Although experiences in the operating room can help surgeons to learn simple bone-drilling techniques, outside training may be better suited for complex procedures. We adapted a rotary handpiece to evaluate the bone-drilling skills of orthopaedic resident physicians during the 2017 Southwest Orthopaedic Trauma Association (SWOTA) motor skills course. Twenty-five postgraduate year (PGY)-1 orthopaedic residents from 7 institutions were asked to perform a bicortical drilling task 3 times both before and after attending a motor skills course. Kinetic and kinematic data were collected using force, acceleration, and visual sensors. Sixteen parameters were measured. The interdependence of these parameters (taken separately for precourse and postcourse performance) is presented. Evidence for motor skill acquisition across a short time scale is elucidated. Noteworthy correlations include overpenetration with force (0.65 mm), palmar-dorsal (P-D) toggle (0.65°), vibration in the P-D direction (0.53 m/s), time (-0.41 sec), and RPM (revolutions per minute; -0.36); time with both RPM (0.38) and P-D toggle (-0.40°); and force with both RPM (-0.41) and P-D toggle (0.32°). Differences in performance before and after the motor skills course include reduction in overpenetration (28.8 to 18.2 mm), reduction in skiving (22% to 6%), and reduction in preparation time (27.3 to 9.65 sec). Additionally, there were several differences in performance by institution that were significant (overpenetration, toggle in the P-D and radial-ulnar [R-U] directions, and both drilling force and drilling time). Understanding how performance and outcome parameters are correlated provides powerful insight into how surgical procedures can be best performed. In particular, we hope that these findings will inform new training paradigms. Variations in resident training from 1 institution to another are evidenced in surgical performance. Similarly, the methods used here to quantify changes in performance across the 3-day SWOTA training course allow a unique vehicle for optimization of these types of training opportunities outside of the operating room.
Sections du résumé
BACKGROUND
BACKGROUND
Although experiences in the operating room can help surgeons to learn simple bone-drilling techniques, outside training may be better suited for complex procedures. We adapted a rotary handpiece to evaluate the bone-drilling skills of orthopaedic resident physicians during the 2017 Southwest Orthopaedic Trauma Association (SWOTA) motor skills course.
METHODS
METHODS
Twenty-five postgraduate year (PGY)-1 orthopaedic residents from 7 institutions were asked to perform a bicortical drilling task 3 times both before and after attending a motor skills course. Kinetic and kinematic data were collected using force, acceleration, and visual sensors.
RESULTS
RESULTS
Sixteen parameters were measured. The interdependence of these parameters (taken separately for precourse and postcourse performance) is presented. Evidence for motor skill acquisition across a short time scale is elucidated. Noteworthy correlations include overpenetration with force (0.65 mm), palmar-dorsal (P-D) toggle (0.65°), vibration in the P-D direction (0.53 m/s), time (-0.41 sec), and RPM (revolutions per minute; -0.36); time with both RPM (0.38) and P-D toggle (-0.40°); and force with both RPM (-0.41) and P-D toggle (0.32°). Differences in performance before and after the motor skills course include reduction in overpenetration (28.8 to 18.2 mm), reduction in skiving (22% to 6%), and reduction in preparation time (27.3 to 9.65 sec). Additionally, there were several differences in performance by institution that were significant (overpenetration, toggle in the P-D and radial-ulnar [R-U] directions, and both drilling force and drilling time).
CONCLUSIONS
CONCLUSIONS
Understanding how performance and outcome parameters are correlated provides powerful insight into how surgical procedures can be best performed. In particular, we hope that these findings will inform new training paradigms. Variations in resident training from 1 institution to another are evidenced in surgical performance. Similarly, the methods used here to quantify changes in performance across the 3-day SWOTA training course allow a unique vehicle for optimization of these types of training opportunities outside of the operating room.
Identifiants
pubmed: 31436666
doi: 10.2106/JBJS.18.00905
pii: 00004623-201908210-00017
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
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