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Teaching basic trauma: validating FluoroSim, a digital fluoroscopic simulator for guide-wire insertion in hip

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FluoroSim, a new digital fluoroscopy simulator, effectively trains orthopedic trauma surgeons without radiation. This inexpensive tool accurately assesses surgical skill, differentiating novice from expert performance in procedures like dynamic hip screw insertion.

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Area of Science:

  • Orthopedic Surgery
  • Medical Simulation
  • Surgical Education Technology

Background:

  • Current fluoroscopic training methods pose radiation risks or are costly and unrealistic.
  • There is a need for safe, effective, and affordable fluoroscopy simulation in orthopedic trauma education.

Purpose of the Study:

  • To introduce and evaluate FluoroSim, a novel, inexpensive digital fluoroscopy simulator.
  • To assess the construct, face, and content validity of FluoroSim in orthopedic training.

Main Methods:

  • A multicenter study involving 26 surgeons performing a simulated guide-wire insertion into a femoral bone.
  • Objective performance metrics (e.g., tip-apex distance, cut-out rate) and surgeon experience (novice, intermediate, expert) were recorded.
  • Face and content validity were assessed using a 7-point Likert scale questionnaire.

Main Results:

  • FluoroSim demonstrated construct validity, with experts and intermediates outperforming novices in key metrics.
  • Statistically significant differences were observed in tip-apex distance and cut-out rates between surgeon groups.
  • Novice surgeons used fewer radiographs, and the simulator showed strong face and content validity.

Conclusions:

  • FluoroSim effectively differentiates surgical skill levels in orthopedic trauma training.
  • The simulator offers a safe, cost-effective, and accessible adjunct for surgical education, complementing existing simulation modalities.