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Updated: Dec 14, 2025
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Published on: August 9, 2024
The Impact of Unguided Trauma Simulation Practice on Novice Performance: A Randomized Controlled Trial
Kevin C Wang1, Eamon D Bernardoni, Eric J Cotter
1From the Department of Orthopaedic Surgery, Mount Sinai Icahn School of Medicine, New York, NY (Dr. Wang), the Department of Orthopaedic Surgery, University of Wisconsin School of Medicine, Madison, WI (Dr. Bernardoni and Dr. Cotter), the Department of Orthopaedic Surgery, Midwest Orthopaedics, Rush University Medical Center, Chicago, IL (Dr. Levine), and the Department of Orthopaedic Surgery, University of Colorado School of Medicine, Denver, CO (Dr. Frank).
Introduction:
The purpose of this investigation was to determine the impact of simulator practice on task completion time, radiation use, success rate, and overall quality in a simulation of placing a distal locking screw.
Methods:
This was a prospective, randomized control trial with one-to-one randomization and parallel group design. Twenty-eight volunteer novice trainees (medical and premedical students) participated. Using the TraumaVision Virtual Reality Simulator (Swemac, Sweden), subjects performed locking screw placement using the "perfect circle" technique. All subjects underwent a pretest and posttest on the simulator. The simulator group completed three additional simulator training sessions. The primary outcome variables were simulator-collected task completion time, success rate, radiation exposure time, and overall score.
Results:
No notable difference existed between groups for pretest completion time, radiation use, success rate, or overall score. No notable difference in posttest radiation use or overall procedure score was found between groups. A significant difference existed in posttest total completion time (trained = 251.2 ± 103.4; control = 497.3 ± 223.1; P = 0.001) and success rate (64.3% versus 100%; P = 0.041) between groups. In addition, a significant difference existed in variance between groups for completion time (P = 0.029).
Conclusions:
These findings suggest that independent simulator practice leads to improved speed and success rates; however, radiation use and overall score do not improve in the same manner. The design of simulator-based curriculum must be tailored to specific educational objectives and ultimately validated in the clinical setting.
