Data for Anterior Plating Technique for Distal Radius: Comparing performance after learning through naive versus deliberate practice

Published: 3 May 2022| Version 1 | DOI: 10.17632/c76nmj3j8r.1
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Description

The objective of this article is to compare the progression in learning curves of junior surgeons trained in the anterior plating technique for the distal radius on a non-biological model according to three different methods. The materials comprised 12 junior surgeons of level 1 or 2 divided into three groups: control (G1), naive practice (G2) and deliberate practice (G3). The three groups watched a demonstration video of a level 5 expert. The four G1 surgeons (two level 1 and two level 2) saw the video only once and each inserted five plates. The four G2 surgeons (two level 1 and two level 2) inserted five plates and watched the video before each time. The four G3 surgeons (two level 1 and two level 2) saw the video before the first plate insertion. Before posing the subsequent four plates, the four G3 surgeons watched their own video and the expert indicated their errors and how to avoid them next time. A 12-criteria OSATS defined on the basis of the 60 videos, each graded from 1 (min.) to 5 (max.) was used to measure the objective surgical performance per plating (min. 12; max. 60) and per series of five plate fixations (min. 60, max. 300). Our results show that deliberate practice is a learning technique for surgical procedures which allows the growth phase of the learning curve to be shortened and the objective performance of junior surgeons to be improved.

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The materials comprised 12 junior surgeons of level 1 or 2 divided into three groups: control (G1), naive practice (G2) and deliberate practice (G3). The three groups watched a demonstration video of a level 5 expert. The four G1 surgeons (two level 1 and two level 2) saw the video only once and each inserted five plates. The four G2 surgeons (two level 1 and two level 2) inserted five plates and watched the video before each time. The four G3 surgeons (two level 1 and two level 2) saw the video before the first plate insertion. Before posing the subsequent four plates, the four G3 surgeons watched their own video and the expert indicated their errors and how to avoid them next time. A 12-criteria OSATS defined on the basis of the 60 videos, each graded from 1 (min.) to 5 (max.) was used to measure the objective surgical performance per plating (min. 12; max. 60) and per series of five plate fixations (min. 60, max. 300). With regard to stress, two electrodes were attached to the skin of each subject (under the right clavicle, under the left nipple) then connected to each other and to the heart rate recording unit. After resting heart rate calibration, the heart rate was recorded continuously from watching the demonstration video to completing A5. An ANI (Analgesia Nociception Index) was measured for each attempt. Its value ranges from 0 (minimal parasympathetic tone or high level of stress) to 100 (maximum parasympathetic tone or low level of stress). The evaluation method was to measure the objective performance (OP), subjective performance (SP) and stress of each subject during each attempt. OP was measured using an analysis of 60 videos using an Objective Structured Assessment of Technical Skill (OSATS) comprising 12 criteria graded from 1 (minimal OP) to 5 (maximal OP) (table I). The OSATS for each plating could range from 12 (minimal OP) to 60 (maximal OP). The total OP for each subject (OSATS A1+A2+A3+A4+A5) could range from 60 to 300. SP was measured using self-evaluation from 0 (no experience) to 10 (expert). Each subject was asked to evaluate their SP in placing a plate on a synthetic model of a radius before A1 (SP1) and after A5 (SP5). Stress was measured for each subject using the difference between ANI after A5 and ANI after A1 (ANI5- ANI1).

Institutions

Hopitaux universitaires de Strasbourg

Categories

Education, Resident Training, Orthopedics Surgery, Surgery Simulation

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