title: Teaching facial fracture repair: A novel method of surgical skills training using three-dimensional biomodels.
abstract: BACKGROUND
  The facial fracture biomodel is a three-dimensional physical prototype of an actual facial fracture. The biomodel can be used as a novel teaching tool to facilitate technical skills training in fracture reduction and fixation, but more importantly, can help develop diagnostic and management competence.
  
  
  OBJECTIVE
  To introduce the 'facial fracture biomodel' as a teaching aid, and to provide preliminary evidence of its effectiveness in teaching residents the principles of panfacial fracture repair.
  
  
  METHODS
  Computer three-dimensional image processing and rapid prototyping were used to generate an accurate physical model of a panfacial fracture, mounted in a silicon 'soft tissue' base. Senior plastic surgery residents in their third, fourth and fifth years of training across Canada were invited to participate in a workshop using this biomodel to simulate panfacial fracture repair. A short didactic presentation outlining the 'patient's' clinical and radiological findings, and key principles of fracture repair, was given by a consultant plastic surgeon before the exercise. The residents completed a pre- and postbiomodel questionnaire soliciting information regarding background, diagnosis and management, and feedback.
  
  
  RESULTS
  A total of 29 residents completed both pre- and postbiomodel questionnaires. Statistically significant results were found in the following areas: diagnosis of all fracture patterns (P=8.2×10(-7) [t test]), choice of incisions for adequate exposure (P=0.04 [t test]) and identifying sequence of repair (P=0.019 [χ(2) test]). Subjective evaluation of workshop effectiveness revealed a statistically significant increase in 'comfort level' only among third year trainees. Overall, positive feedback was reported among all participants.
  
  
  CONCLUSIONS
  Biomodelling is a promising ancillary teaching aid that can assist in teaching residents technical skills, as well as how to assess and plan surgical repair.
authors.affiliation: Undergraduate Medical Education, Faculty of Medicine, University of Toronto;
authors.forename: Neil
authors.initials: N
authors.lastname: D'Souza
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario.
authors.forename: James
authors.initials: J
authors.lastname: Mainprize
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario.
authors.forename: Glenn
authors.initials: G
authors.lastname: Edwards
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario ; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario.
authors.forename: Paul
authors.initials: P
authors.lastname: Binhammer
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario ; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Toronto, Toronto, Ontario.
authors.forename: Oleh
authors.initials: O
authors.lastname: Antonyshyn
keywords: 3D biomodel; Facial fracture repair; Plastic surgery; Surgical education