Freestyle Deliberate Practice Cadaveric Hand Surgery Simulation Training for Orthopedic Residents: Cohort Study

Area of Science:

• Surgical Education
• Medical Simulation
• Orthopedic Surgery Training

Background:

• Cadaveric simulation training offers a solution to reduced operative surgical training quantity and quality.
• It allows surgical learning to occur in a laboratory setting, away from patients.
• Deliberate practice (DP) theory may enhance the educational impact of cadaveric simulation.

Purpose of the Study:

• To assess the impact of freestyle DP cadaveric hand surgery simulation on self-reported operative confidence.
• To evaluate the subjective transfer validity, perceived educational value, and simulation fidelity of the training.

Main Methods:

• Validated questionnaires assessed training impact on orthopedic surgery residents (PGY 5-10).
• Freestyle course structure enabled personalized learning objectives through DP.
• Study conducted at Keele Anatomy and Surgical Training Centre, UK, with 22 residents.

Main Results:

• Junior residents (PGY 5-6) showed the greatest confidence gains, diminishing with seniority.
• Confidence gains correlated with procedural complexity; more complex procedures yielded greater gains.
• Midstage residents reported highest educational benefit but lower perceived realism; senior residents preferred the freestyle nature.

Conclusions:

• Freestyle, resident-directed cadaveric simulation optimizes DP for individualized learning needs.
• Intensive, directed feedback facilitates rapid skill acquisition.
• High subjective transfer validity was reported, necessitating future objective validation.