Simulation to Support Competency-Based Training in Orthopedic Trauma

支持骨科创伤能力培训的模拟

• 批准号: 9358414
• 负责人: Donald D Anderson
• 金额: $ 40万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-30 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9358414
• 关键词: Simulation; Support; Competency; Based; Training

Project Summary/Abstract The long-term goal of our research program is to develop the scientific evidence needed to bring competency- based evaluation of surgical skills to orthopedics. The objective of this application is to provide the orthopedic training community with scientifically defendable criteria for critical orthopedic surgical skills at three key developmental points in surgical residency: ready to operate, ready to lead a surgery supervised by faculty, and ready for independent practice. The central hypothesis of this project is that orthopedic surgical skill competence can be objectively, quantitatively, and reliably measured from surgical results that impact patient safety. This hypothesis is based on previous multi-institutional simulation studies conducted with residency programs throughout the Midwest region. The proposed research explores training and assessment programs with several novel surgical simulators. It will also explore ground-breaking analysis techniques for assessing operating room performance from surgical radiographs and from computational, image-based, 3D model reconstruction. This project further expands previous work to more residency programs and to two national ortho- pedic organizations: the Orthopedic Trauma Association, which offers training programs to over a hundred residents sev- eral times a year, and to the American Board of Orthopedic Surgeons, which reviews the credentials and skills of 900 or- thopedic surgeons each year, certifying many to become official diplomates of ABOS. The participation of these national organizations, which provide a large number of potential research participants, creates the opportunity for achieving exciting new research goals, including these three specific aims. Specific Aim 1 is to measure orthopedic trauma surgery skill through surgical results. The working hypothesis for this aim is that sur- gical skill in orthopedic trauma can be measured by analyzing radiographic images associated with a surgery. Specific Aim 2 is to develop simulator-based training programs that improve surgical results. The working hypothesis is that residents who practice key skills until achieving proficiency will perform better in the operating room than residents with- out training. Specific Aim 3 is to define simulator-based assessments that generalize to clinical performance. The working hypothesis is that simulator assessment measurements will discriminate among levels of surgical skill and will also generalize across surgical tasks and between simulation and clinical practice. The proposed research will provide a safe environment for orthopedic surgeons to acquire valuable experience without putting patients at risk. It will also help to establish reliable measures of clinical performance competency and their potential use for credentialing and certification. Finally, as new simulation capabilities become available over the ensuing years, this work will have successfully shown the way from development to changing practice.

项目概要/摘要 我们研究计划的长期目标是开发带来能力所需的科学证据—— 基于骨科手术技能的评估。该应用程序的目的是提供骨科培训 在三个关键发展点上对关键骨科手术技能具有科学依据的标准的社区 外科住院医师实习：准备好手术，准备好在教师的监督下领导手术，并准备好独立实践。 该项目的中心假设是骨科手术技能能力可以客观、定量、 根据影响患者安全的手术结果进行可靠测量。这一假设是基于之前的多机构研究 通过整个中西部地区的住院医师项目进行模拟研究。拟议的研究探索 使用几种新颖的手术模拟器进行培训和评估计划。它还将探索突破性的分析 通过手术射线照片和基于图像的计算 3D 评估手术室性能的技术 模型重建。该项目进一步将之前的工作扩展到更多的住院医师计划和两个国家正交项目 外科组织：骨科创伤协会，该协会为一百多名居民提供培训计划 每年几次，以及美国骨科医生委员会，该委员会审查 900 名或 每年都有骨科医生参加，认证许多人成为 ABOS 的官方外交官。 这些国家组织的参与，提供了大量潜在的研究参与者， 为实现令人兴奋的新研究目标（包括这三个具体目标）创造了机会。具体目标 1 是 通过手术结果来衡量骨科创伤手术技能。该目标的工作假设是 sur- 骨科创伤的技能可以通过分析与手术相关的放射线图像来测量。具体的 目标 2 是开发基于模拟器的培训计划，以改善手术效果。工作假设是 练习关键技能直至熟练的住院医师在手术室中的表现会比以下住院医师更好： 外出训练。具体目标 3 是定义可推广到临床表现的基于模拟器的评估。这 工作假设是模拟器评估测量将区分手术技能水平，并且将 还可以概括手术任务以及模拟和临床实践之间的关系。 拟议的研究将为骨科医生提供一个安全的环境来获得宝贵的经验 而不会将患者置于危险之中。它还将有助于建立可靠的临床表现能力衡量标准和 它们在资格认证和认证方面的潜在用途。最后，随着新的模拟功能的出现 在接下来的几年里，这项工作将成功地展示了从发展到改变实践的道路。