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A Novel Approach to Teaching Visual-spatial Skills in Wire Navigated Procedures

A Novel Approach to Teaching Visual-spatial Skills in Wire Navigated Procedures. Jenniefer Y. Kho , M.D. J. L. Marsh, MD, Geb Thomas, PhD, Brian Johns, MS, Don Anderson, PhD University of Iowa Hospitals and Clinics. Aided by a Grant from the Orthopaedic Research and Education Foundation.

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A Novel Approach to Teaching Visual-spatial Skills in Wire Navigated Procedures

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  1. A Novel Approach to Teaching Visual-spatial Skills in Wire Navigated Procedures Jenniefer Y. Kho, M.D. J. L. Marsh, MD, Geb Thomas, PhD, Brian Johns, MS, Don Anderson, PhD University of Iowa Hospitals and Clinics

  2. Aided by a Grant from the Orthopaedic Research and Education Foundation

  3. Introduction Surgical simulation in orthopaedic trauma is lacking

  4. Benchtop models Leong et al. Validation of orthopaedic bench models for trauma surgery. JBJSBr 2008. Atesok. Surgcial Simulation in Orthopaedic Skills Training. JAAOS 2012;20:410-422.

  5. Yehyawi et al. A simulation trainer for complex articular fracture surgery. JBJS 2013.

  6. Virtual Reality Simulator Blyth. A simulation-based training system for hip fracture fixation for use within the hospital environment. Injury 2007.

  7. Haptic-based simulator Froelich et al. Surgical Simulators and Hip Fracture: A Role in Residency Training? Journal of Surgical Education 2011.

  8. Background Wire navigation, or the ability to target a wire to a precise location through an osseous trajectory, is a fundamental skill in orthopaedic surgery.

  9. Aims • Develop a radiation-free electromagnetic sensor-based wire navigation simulator in a proximal femur model • Determine if simulator training improves performance in novice (PGY-1) surgeons • Compare novice and expert (senior residents/staff) surgeons

  10. TrakStar simulator development

  11. Methods

  12. Methods - Tip-apex-distance - Time - # fluoro shots - # of attempts

  13. Methods

  14. Methods Trial 1 TAD 20.9mm – 53 images Trial 2 TAD 17.8mm – 50 images Trial 3 TAD 12.05mm – 42 images

  15. Methods - Tip-apex-distance - Time - # fluoro shots - # of attempts

  16. PGY-4/Staff Methods - Tip-apex-distance - Time - # fluoro shots - # of attempts

  17. Results Table 1. Pre vs posttest (PGY-1) * Mean+SD

  18. Results Table 2. Novice vs expert surgeons * Mean+SD

  19. Results of simulator practice in all groups

  20. Results of simulator practice in all groups

  21. Discussion • TrakStarwire navigation simulator can distinguish novice and expert surgeons • Increased TAD in novice surgeons • Practice on the simulator leads to decreased time and fluoroscopic shots, but no difference in TAD (actually increased)

  22. Discussion • Simulator needs to be affordable, user-friendly, demonstrate validity • Trakstar is expensive • Need further validation studies • Currently testing the simulator in graduate students and more senior surgeons

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