Do Skills Acquired from Training with a Wire Navigation Simulator Transfer to a Mock Operating Room Environment?

Area of Science:

• Orthopaedic surgical education
• Medical simulation
• Surgical skills training

Background:

• Simulation is crucial for improving operating room performance (transfer validity).
• Prior studies lack data on simulator-based wire navigation training transfer to advanced tasks.
• The optimal format for wire navigation training remains unknown.

Purpose of the Study:

• To determine which training method (didactic, deliberate practice, proficiency-based) best improves wire navigation task performance.
• To assess if resident performance on a wire navigation simulator correlates with performance in a simulated operating room environment.

Main Methods:

• Fifty-five residents were divided into didactic, deliberate practice, and proficiency training groups.
• Deliberate practice involved simulator training with immediate feedback; proficiency training focused on mastering components.
• Performance was assessed in a mock operating room using fluoroscopy, time, and tip-apex distance.

Main Results:

• Simulation-based training groups achieved significantly lower tip-apex distance than the didactic group (p<0.001).
• Proficiency training residents used more images (p=0.012).
• Simulator performance (tip-apex distance, image use, time) correlated with mock OR performance (r-square up to 0.61, p<0.001).

Conclusions:

• Residency curricula should emphasize deliberate practice with immediate feedback for wire navigation skills.
• Surgical simulators provide a safe and effective environment for learning wire navigation.