Trauma simulation training: a randomized controlled trial -evaluating the effectiveness of the Imperial Femoral Intramedullary Nailing Cognitive Task Analysis (IFINCTA) tool.

Background and purpose — Cognitive task analysis (CTA) has been used extensively to train pilots and in other surgical specialties. However, the use of CTA within orthopedics is in its infancy. We evaluated the effectiveness of a novel CTA tool to improve understanding of the procedural steps in ant...

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Publicado en:Acta Orthopaedica Vol. 89; no. 6; pp. 689 - 696
Autores principales: Bhattacharyya, Rahul, Sugand, Kapil, Al-Obaidi, Bilal, Sinha, Ian, Bhattacharya, Rajarshi, Gupte, Chinmay M
Formato: diagnostic images pictorial research tables/charts randomized controlled trial Journal Article
Publicado: Medical Journals Sweden AB Dec2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2018
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      pub: Medical Journals Sweden AB
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        10.1080/17453674.2018.1517442
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        atl: Trauma simulation training: a randomized controlled trial -evaluating the effectiveness of the Imperial Femoral Intramedullary Nailing Cognitive Task Analysis (IFINCTA) tool.
      aug:
        au:
          Bhattacharyya, Rahul
          Sugand, Kapil
          Al-Obaidi, Bilal
          Sinha, Ian
          Bhattacharya, Rajarshi
          Gupte, Chinmay M
        affil: MSK Lab, Imperial College London, Charing Cross Hospital Campus, Laboratory Block, London
      sug:
        subj:
          Surgeons Psychosocial Factors
          Multimedia
          Clinical Competence Evaluation
          Cognition
          Task Performance and Analysis
          Fracture Fixation Methods
          Computer Simulation
          Human
          Randomized Controlled Trials
          Delphi Technique
          Audiovisuals
          Double-Blind Studies
          Students, Medical Psychosocial Factors
          Mobile Applications
          Decision Making, Clinical
          Orthopedic Care
      ab: Background and purpose — Cognitive task analysis (CTA) has been used extensively to train pilots and in other surgical specialties. However, the use of CTA within orthopedics is in its infancy. We evaluated the effectiveness of a novel CTA tool to improve understanding of the procedural steps in antegrade femoral intramedullary nailing. Material and methods — Design: A modified Delphi technique was used to generate a CTA from 3 expert orthopedic trauma surgeons for antegrade femoral intramedullary nailing. The written and audiovisual information was combined to describe the technical steps, decision points, and errors for each phase of this procedure Validation: A randomized double-blind controlled trial was undertaken with 22 medical students (novices) randomized into 2 equal groups. The intervention group were given the CTA tool and the control group were given a standard operative technique manual. They were assessed using the validated "Touch Surgery™" application assessment tool on femoral intramedullary nailing. Results — The pre-test scores between the two groups were similar. However, the post-test scores were statistically significantly better in the intervention group compared with the control group. The improvement (post-test median scores) in the intervention group compared with the control group was 20% for patient positioning and preparation, 21% for femoral preparation, 10% for proximal locking, and 19% for distal locking respectively (p < 0.001 for all comparisons). Interpretation — This is the first multimedia CTA tool in femoral intramedullary nailing that is easily accessible, user-friendly, and has demonstrated significant benefits in training novices over the traditional use of operative technique manuals.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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