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Improving Patient Safety in Orthopaedic Trauma Surgical Training

提高骨科创伤手术培训中的患者安全

基本信息

批准号：
8742427
负责人：
Donald D Anderson
金额：
$ 73.99万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-01 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8742427
关键词：
Improving Patient Safety Orthopaedic Trauma

项目摘要

Project Summary / Abstract Orthopaedic surgical skills are largely acquired through apprenticeship in the operating room (OR). This expensive and unforgiving training model struggles to ensure patient safety. The long-term goal of this work is to improve patient safety and outcomes by providing effective simulation tools. The work is significant in that it will provide rigorous scientific evidence that a surgical simulator can improve an orthopaedic resident's OR performance. A common and important skill that orthopaedic residents learn is to drive a sharpened stainless steel pin along a precise path within bone. This task, commonly called wire navigation, is a part of treating many common fractures. The task requires surgeons to rely on 2D fluoroscopic imaging to assess progress of the wire within the bone. Precisely controlling the position of the wire is critical to patient safety and fixation strength. A simulator has been developed to mimic wire navigation in one of the most common surgeries in orthopaedics: the fixing of a fracture of the proximal femur. The augmented reality simulator blends a real drill and surrogate femur with computer-generated fluoroscopic images. The simulator closely replicates the sensation of drilling in the OR while retaining the benefit of a radiation-free training environment. Task performance is assessed upon completion by measuring several important quantities, which can likewise be directly measured in the OR. The specific objective of the proposed research is to measure the effectiveness of using the new simulator to train residents in wire navigation. The central hypothesis is that the simulator reproduces critical elements of actual wire navigation. The following aims will be pursued. Aim 1: Demonstrate how deliberate practice improves wire navigation performance. Multi-institutional studies involving nearly 300 orthopaedic residents will be undertaken to measure the learning curve for acquiring wire navigation skill on the radiation-free simulator. Prior to progressing to the OR, studies will be conducted to show that simulator performance improves performance on a surgical simulation involving actual fluoroscopy. Aim 2: Show that simulator performance correlates with performance in the OR. Additional studies will be conducted to demonstrate that skill assessments with the simulator distinguish junior orthopaedic residents from senior residents. Additional studies will be conducted to determine if performance on the simulator correlates with OR performance. The proposed series of studies link training and assessment in the skills lab to performance in the OR. This paves the way for developing, testing, and improving simulators within orthopaedic surgery. An experienced research team has been assembled, and a commercial partner is ready to foster wider dissemination of the simulator. Increased resident skill in wire navigation gained outside of the OR will spare patients unnecessary additional risk, lead to faster procedures, yield better surgical results, and ultimately provide better patient outcomes.

项目摘要/摘要

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Assessing Wire Navigation Performance in the Operating Room.

评估手术室中的有线导航性能。

DOI：
10.1016/j.jsurg.2016.03.018
发表时间：
2016
期刊：
Journal of surgical education
影响因子：
2.9
作者：
Taylor,LeahK;Thomas,GebW;Karam,MatthewD;Kreiter,ClarenceD;Anderson,DonaldD
通讯作者：
Anderson,DonaldD

Skill Assessment in the Interpretation of 3D Fracture Patterns from Radiographs.

从射线照片解释 3D 骨折模式的技能评估。

DOI：
发表时间：
2016
期刊：
The Iowa orthopaedic journal
影响因子：
0
作者：
Thomas,GebW;Rojas-Murillo,Salvador;Hanley,JessicaM;Kreiter,ClarenceD;Karam,MatthewD;Anderson,DonaldD
通讯作者：
Anderson,DonaldD

Designing an Affordable Wire Navigation Surgical Simulator.

设计经济实惠的有线导航手术模拟器。