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· DOS Abstracts
Exploring learning curves for simulation-based hip-
fracture surgery
Amandus Gustafsson, Poul Pedersen, Henrik Palm, Lars Konge
Copenhagen Academy for Medical Education and Simulation, The Capital
Region of Denmark; Department of Orthopedics, Copenhagen University
Hospital Hvidovre; Hip Fracture Unit, Department of Orthopedics, Copenhagen
University Hospital Hvidovre; Copenhagen Academy for Medical Education and
Simulation, The Capital Region of Denmark
Background:
Inexperienced orthopedic interns can contribute to a higher reop-
eration rate in hip fracture surgery. Computer-simulation has improved opera-
tive skills in other surgical specialties and mandatory training to proficiency on a
hip fracture surgery simulator should be considered for orthopedic interns.
Purpose / Aim of Study:
The aims of this study were to explore how much
simulation training orthopedic interns need for reaching the plateau phase of
their learning curve and to define a pass/fail standard for mastery learning based
on the level of the plateaus.
Materials and Methods:
Sixteen orthopedic interns were included for simula-
tion with cannulated screws, Hansson Pins and Sliding Hip Screw on the Swemac
TraumaVision, which has a scoring system with validity evidence. The scores as a
percentage of maximum for the three procedures were combined to one aver-
age total score. The training ceased when an intern failed to improve the total
score for three consecutive times.
Findings / Results:
The orthopedic interns practiced the three procedures
eight to 18 times, average 179 minutes (110-246 minutes). Participants im-
proved significantly and performed more consistently after training, initial score
= 71.2 (SD 11.0) and maximum score = 94.5 (SD 4.0). Maximum score above
90 points was achieved after a mean of 145 minutes (59-241 minutes). There
was a significant correlation between the initial score and the maximum score
(Pearson’s r=0.51, p=0.046).
Conclusions:
Performance improved for all, but with large variations in the in-
dividual progression and the initial performance to some degree predicting the
max score. There was no correlation between the time spend practicing and the
maximum score, but all interns except one could achieve a max score above 90,
which we suggest as a pass standard in a formal mastery learning simulation
program.
No conflicts of interest reported
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