A Cadaver-Based Course for Humanitarian Surgery Improves Manual Skill in Powerless External Fixation

Area of Science:

• Medical Education
• Surgical Skills Training
• Humanitarian Medicine

Background:

• Humanitarian careers require specialized skills beyond standard surgical residency.
• The Colorado Humanitarian Surgical Skills Workshop offers low-resource training for senior residents.
• Focus on manual competence in powerless lower extremity external fixation for critical humanitarian scenarios.

Purpose of the Study:

• To assess the effectiveness of a humanitarian surgical skills workshop in teaching external fixation.
• To evaluate the improvement in manual competence and confidence among surgical residents.
• To establish a standardized assessment for humanitarian surgical skills.

Main Methods:

• Development of a novel manual skills test for powerless lower extremity external fixation.
• Pre- and post-workshop assessment of cadaveric fracture stabilization by senior surgical residents.
• Didactic instruction and hands-on practice in external fixation techniques.
• Standardized scoring of fixator constructs and pre/post-confidence surveys.

Main Results:

• Significant improvement in external fixator construct scores (23% to 75%, P < 0.01).
• Increased proficiency in completing the exercise within time limits and achieving stable, aligned constructs.
• Marked enhancement in participants' self-reported confidence with external fixation.

Conclusions:

• A short, cadaver-based workshop significantly improves surgical residents' manual skills and confidence in low-resource external fixation.
• The training demonstrates potential for enhancing readiness for humanitarian surgical missions.
• Additional training is necessary to bridge the gap between workshop skills and full clinical competence.