Development and Validation of SCFE Percutaneous Pinning Surgical Simulation

Area of Science:

• Orthopaedic Surgery
• Medical Simulation
• Surgical Education

Background:

• Slipped capital femoral epiphysis (SCFE) in adolescents often requires in situ screw fixation.
• Percutaneous femoral screw fixation is a common procedure with inherent risks.
• Surgical simulation can offer a safe environment for trainees to refine skills before operating on patients.

Purpose of the Study:

• To develop and validate a synthetic surgical model for simulating in situ percutaneous fixation of SCFE.
• To assess the construct validity, face validity, and interrater reliability of the simulation model.
• To evaluate the simulation's effectiveness as an educational tool for orthopaedic trainees.

Main Methods:

• A synthetic SCFE model was used for simulated in situ percutaneous fixation.
• Orthopaedic attendings (n=5) and trainees (n=20) performed the procedure.
• Performance metrics (time, radiation exposure, radiographs) and subjective feedback (questionnaires) were collected.
• Two blinded surgeons assessed technical proficiency using the Global Rating Scale (GRS) and radiographic grading.

Main Results:

• Attendings showed significantly higher GRS scores and better radiographic screw placement than trainees.
• Attendings had shorter operative times and less radiation exposure compared to trainees.
• The simulation demonstrated excellent interrater reliability for both GRS and radiographic grading.
• Both groups rated the simulation highly for realism and teaching utility.

Conclusions:

• The developed surgical simulation is a valid and reliable measure of technical competency for SCFE fixation.
• The simulation shows significant promise as a formative educational tool for orthopaedic residency programs.
• This model can aid in improving surgical skills and patient safety in SCFE treatment.