Skill Acquisition and Retention Following Simulation-Based Training in Pavlik Harness Application.

Background: Simulation-based learning is increasingly prevalent in many surgical training programs, as medical education moves toward competency-based curricula. In orthopaedic surgery, developmental dysplasia of the hip is a commonly treated condition, where the standard of care for patients less t...

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Publicado en:Journal of Bone & Joint Surgery, American Volume Vol. 98; no. 10; pp. 866 - 871
Autores principales: Moktar, Joel, Bradley, Catharine S., Maxwell, Alexandra, Wedge, John H., Kelley, Simon P., Murnaghan, M. Lucas
Formato: Journal Article
Publicado: Lippincott Williams & Wilkins 5/18/2016
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Journal of Bone & Joint Surgery, American Volume
      issn: 00219355
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    pubinfo:
      dt: 5/18/2016
      vid: 98
      iid: 10
      pid: 433
      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        115469327
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        10.2106/JBJS.15.00905
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        115469327
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        atl: Skill Acquisition and Retention Following Simulation-Based Training in Pavlik Harness Application.
      aug:
        au:
          Moktar, Joel
          Bradley, Catharine S.
          Maxwell, Alexandra
          Wedge, John H.
          Kelley, Simon P.
          Murnaghan, M. Lucas
        affil: Investigation performed at the Division of Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
      sug:
        subj:
          Orthopedic Surgery Standards
          Orthopedic Surgery Education
          Memory
          Hip Dislocation, Congenital Therapy
          Orthoses
          Clinical Competence Standards
          Educational Measurement
          Retrospective Design
          Videorecording
          Orthopedic Surgery Methods
          Models, Anatomic
          Scales
      ab: Background: Simulation-based learning is increasingly prevalent in many surgical training programs, as medical education moves toward competency-based curricula. In orthopaedic surgery, developmental dysplasia of the hip is a commonly treated condition, where the standard of care for patients less than six months of age is an orthotic device such as the Pavlik harness. However, despite widespread use of the Pavlik harness and the potential complications that may arise from inappropriate application, we know of no previously described formal training curriculum for Pavlik harness application.Methods: We developed a video and model-based simulation learning module for Pavlik harness application. Two novice groups (residents and allied health professionals) were exposed to the module and, at pre-intervention, post-intervention, and retention testing, were evaluated on their ability to apply a Pavlik harness to the model. Evaluations were completed using a previously validated Objective Structured Assessment of Technical Skills (OSATS) and a global rating scale (GRS) specific to Pavlik harness application. A control group that did not undergo the module was also evaluated at two time points to determine if exposure to the Pavlik harness alone would affect skill acquisition. All groups were compared with a group of clinical experts, whose scores were used as a competency benchmark. Statistical analysis of skill acquisition and retention was conducted using t tests and analysis of variance (ANOVA).Results: Exposure to the learning module improved resident and allied health professionals' competency in applying a Pavlik harness (p < 0.05) to the level of the expert clinicians, and this level of competency was retained one month after exposure to the module. Control subjects who were not exposed to the module did not improve, nor did they achieve competency.Conclusions: The simulation-based learning module was shown to be an effective tool for teaching the application of a Pavlik harness, and learners demonstrated retainable skills post-intervention. This learning module can form the cornerstone of formal teaching of Pavlik harness application for developmental dysplasia of the hip.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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