Trauma simulation training: a randomized controlled trial -evaluating the effectiveness of the Imperial Femoral Intramedullary Nailing Cognitive Task Analysis (IFINCTA) tool.
Trauma simulation training: a randomized controlled trial -evaluating the effectiveness of the Imperial Femoral Intramedullary Nailing Cognitive Task Analysis (IFINCTA) tool.
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DOI：
10.1080/17453674.2018.1517442
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发表时间：
2018-12
影响因子：
3.7
通讯作者：
Gupte CM
中科院分区：
文献类型：
--
作者：
Bhattacharyya R;Sugand K;Al-Obaidi B;Sinha I;Bhattacharya R;Gupte CM
背景和目的 — 认知任务分析 (CTA) 已广泛用于培训飞行员和其他外科专业。然而，CTA 在骨科领域的应用还处于起步阶段。我们评估了一种新型 CTA 工具的有效性，以提高对顺行股骨髓内钉手术步骤的理解。材料和方法 — 设计：使用改良的德尔菲技术，由 3 名骨科创伤外科医生进行顺行股骨髓内钉治疗生成 CTA。结合书面和视听信息来描述该程序每个阶段的技术步骤、决策点和错误。 验证：进行了一项随机双盲对照试验，将 22 名医学生（新手）随机分为 2 个相等的组。干预组给予CTA工具，对照组给予标准手术技术手册。他们使用经过验证的“TouchSurgery™”应用评估工具对股骨髓内钉进行评估。结果——两组之间的预测试分数相似。然而，与对照组相比，干预组的测试后成绩在统计学上显着更好。与对照组相比，干预组的患者定位和准备、股骨准备、近端锁定和远端锁定的改善（测试后中位数分数）分别为 20%、10% 和 19%（所有比较 p < 0.001）。解释 — 这是股骨髓内钉治疗中第一个多媒体 CTA 工具，易于使用、用户友好，并且与传统使用手术技术手册相比，在培训新手方面显示出显着的优势。
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.
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