title: Effectiveness of a Low-Cost Drilling Module in Orthopaedic Surgical Simulation.
abstract: BACKGROUND
  Financial pressures and resident work hour regulations have led to adjunct means of resident education such as surgical simulation. The purpose of this study is to determine the effectiveness of a hands-on training session in orthopaedic drilling technique educational model during a surgical simulation on reducing drill plunging depth and to determine the effectiveness of senior residents teaching a hands-on training session in orthopaedic drilling technique.
  
  
  METHODS
  A total of 13 participants (5 orthopaedic interns and 8 medical students) drilled until they penetrated the far cortex of a synthetic bone model and the plunging depth (PD) was measured. They were then randomized and underwent an education session with an attending orthopaedic surgeon or a senior resident. Next, the subjects drilled again with the PD being calculated. The preeducational and posteducational session were compared to determine if there was any improvement in PD and if there was a difference between educators. The cost of the model was also determined.
  
  
  RESULTS
  The mean maximum PD and mean PD before the education session was 1.58 (1.40-2.10) and 1.50cm (1.36-1.76), respectively. Following the educational session, the mean maximum PD and mean PD were 0.53 (0.42-0.75) and 0.50cm (0.40-0.72), respectively. These were both significantly lower than before the education session (p <0.05). After the educational session taught by the attending versus the session taught by the resident, the mean maximum PD was 0.59 (0.42-0.75) and 0.49cm. (0.45-0.75), respectively (p = 0.44). After the educational session taught by the attending versus the session taught by the resident, the mean PD was 0.54 (0.40-0.72) and 0.47cm. (0.40-0.65), respectively (p = 0.44). The cost of the station per participant was $5.44.
  
  
  CONCLUSIONS
  This study demonstrated a significant reduction in drilling PD with use of a low-cost training model and a formal didactic and skills session on proper drilling technique that can effectively be led by senior residents.
authors.affiliation: Department of Orthopaedic Surgery Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: John A
authors.initials: JA
authors.lastname: Ruder
authors.affiliation: Department of Orthopaedic Surgery Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Blake
authors.initials: B
authors.lastname: Turvey
authors.affiliation: Department of Orthopaedic Surgery Carolinas Medical Center, Charlotte, North Carolina.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Hsu
authors.affiliation: Department of Orthopaedic Surgery Carolinas Medical Center, Charlotte, North Carolina. Electronic address: Brian.scannell@carolinashealthcare.org.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Scannell
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000818:Animals; D002983:Clinical Competence; D003362:Cost-Benefit Analysis; D004503:Education, Medical, Graduate / Q000191:economics / Q000379:methods; D006801:Humans; D007396:Internship and Residency / Q000191:economics / Q000379:methods; D017145:Models, Educational; D061646:Operative Time; D019637:Orthopedic Procedures / Q000193:education* / Q000295:instrumentation*; D009985:Orthopedics / Q000193:education; D000066908:Simulation Training / Q000191:economics* / Q000379:methods; D013337:Students, Medical / Q000706:statistics & numerical data
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; bicortical drilling; cost effectiveness; drill plunging; resident education; surgical simulation