title: Feasibility and fidelity of practising surgical fixation on a virtual ulna bone.
abstract: BACKGROUND
  Surgical simulators provide a safe environment to learn and practise psychomotor skills. A goal for these simulators is to achieve high levels of fidelity. The purpose of this study was to develop a reliable surgical simulator fidelity questionnaire and to assess whether a newly developed virtual haptic simulator for fixation of an ulna has comparable levels of fidelity as Sawbones.
  
  
  METHODS
  Simulator fidelity questionnaires were developed. We performed a stratified randomized study with surgical trainees. They performed fixation of the ulna using a virtual simulator and Sawbones. They completed the fidelity questionnaires after each procedure.
  
  
  RESULTS
  Twenty-two trainees participated in the study. The reliability of the fidelity questionnaire for each separate domain (environment, equipment, psychological) was Cronbach α greater than 0.70, except for virtual environment. The Sawbones had significantly higher levels of fidelity than the virtual simulator (p < 0.001) with a large effect size difference (Cohen d < 1.3).
  
  
  CONCLUSIONS
  The newly developed fidelity questionnaire is a reliable tool that can potentially be used to determine the fidelity of other surgical simulators. Increasing the fidelity of this virtual simulator is required before its use as a training tool for surgical fixation. The virtual simulator brings with it the added benefits of repeated, independent safe use with immediate, objective feedback and the potential to alter the complexity of the skill.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Calgary, Calgary, Alta. leblanc.justin@me.com
authors.forename: Justin
authors.initials: J
authors.lastname: LeBlanc
authors.forename: Carol
authors.initials: C
authors.lastname: Hutchison
authors.forename: Yaoping
authors.initials: Y
authors.lastname: Hu
authors.forename: Tyrone
authors.initials: T
authors.lastname: Donnon
mesh_terms: D003198:Computer Simulation; D004521:Educational Measurement; D005240:Feasibility Studies; D005592:Fracture Fixation; D006801:Humans; D008954:Models, Biological; D009985:Orthopedics / Q000193:education*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014458:Ulna Fractures / Q000601:surgery*