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High-Fidelity Cleft Simulation Maintains Improvements in Performance and Confidence: A Prospective Study
Carolyn R Rogers-Vizena1, Francesca Y L Saldanha2, Georgios D Sideridis3
1Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts; Boston Children's Hospital Immersive Design Systems, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Journal of Surgical Education
|September 7, 2023
Summary
High-fidelity simulation and debriefing significantly improved cleft lip repair skills and confidence. These gains were maintained at three months, suggesting simulation accelerates surgical training.
Area of Science:
- Medical Education
- Surgical Simulation
- Plastic Surgery Training
Background:
- High-fidelity simulation is increasingly utilized in plastic surgical education.
- Cleft lip repair is a complex procedure requiring specialized training.
Purpose of the Study:
- To evaluate the impact of high-fidelity cleft lip repair simulation with structured debriefing on trainee performance and self-confidence.
- To assess the maintenance of these improvements over time.
Main Methods:
- A prospective, single-blinded interventional study involving 26 surgical trainees.
- Trainees underwent cleft lip repair simulation, followed by debriefing, with repeated assessments at baseline, immediately after, and 3 months later.
- Performance was evaluated using the modified Objective Structured Assessment of Technical Skills (OSATS) and the Unilateral Cleft Lip Repair (UCLR) competency assessment tool, alongside self-assessed confidence surveys.
Main Results:
- Significant improvements (p < 0.05) were observed in OSATS, UCLR scores, and procedural self-confidence after the initial simulation and debriefing.
- Self-assessed cleft lip knowledge and confidence also significantly improved between the second and third simulations.
- Performance improvements were maintained at the 3-month follow-up, and simulation reduced performance disparities related to training level.
Conclusions:
- High-fidelity simulation coupled with structured debriefing effectively enhances objective surgical performance and subjective self-confidence in cleft lip repair.
- The observed improvements are durable, persisting at 3 months post-intervention.
- Simulation-based training appears to accelerate skill acquisition and may help to equalize performance across different training levels.
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