title: Education of parents in Pavlik harness application for developmental dysplasia of the hip using a validated simulated learning module.
abstract: BACKGROUND
  The Pavlik harness is the most common initial treatment for developmental dysplasia of the hip worldwide. During treatment, parents are required to re-apply the harness at home. Teaching parents how to apply the harness is therefore paramount to success. While simulated learning for medical training is commonplace, it has not yet been trialed in teaching parents how to apply a Pavlik harness.
  
  
  METHODS
  A group of parents underwent a simulated learning module for Pavlik harness application. Parents were evaluated pre- and post-exposure and at one month after testing. A validated objective structured assessment of technical skill (OSATS) and a global rating scale (GRS) specific to Pavlik harness application were used for evaluation. A control group of parents was also tested at both time points. A clinical expert group was used to determine competency. ANOVA and t tests were used to assess differences between groups and over time.
  
  
  RESULTS
  Parent scores on the OSATS improved to the level of expert clinicians both immediately post-intervention and at retention testing. However, on the GRS, only half were considered competent due to their inability to achieve the required hip positions. The control group did not improve nor were they considered competent.
  
  
  CONCLUSIONS
  The use of a simulated learning module improves both the confidence and skill level of parents in the application of the Pavlik harness. However, the challenges parents face in understanding the more detailed subtleties of medical care suggest that they still require an appropriate level of supervision by clinicians to ensure effective treatment.
authors.affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Gargan
authors.affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
authors.forename: Catharine S
authors.initials: CS
authors.lastname: Bradley
authors.affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Maxwell
authors.affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
authors.forename: Joel
authors.initials: J
authors.lastname: Moktar
authors.affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
authors.forename: John H
authors.initials: JH
authors.lastname: Wedge
authors.affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
authors.forename: M Lucas
authors.initials: ML
authors.lastname: Murnaghan
authors.affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. simon.kelley@sickkids.ca.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Kelley
keywords: Developmental dysplasia of the hip; Parent education; Pavlik harness; Pediatric orthopedics; Simulated learning