Implementation of a Simulation-Based Cast Saw Technique Educational Module to Improve Cast Removal Safety

Despite the increasing operative demands in orthopaedic residency, the teaching of fundamental nonoperative skills-such as safe cast removal-remains insufficient. Improper cast saw technique can result in burns, abrasions, scarring, infection, and significant medicolegal and healthcare burdens. Although formal cast saw training programs improve safety, they often require substantial personnel and financial resources, limiting widespread implementation. A validated wax-based simulation model developed by our group offers a cost-effective, reproducible method for assessing cast saw safety. This study evaluated the effectiveness of a structured cast saw training module using this simulation model in novice learners.

A total of 42 medical students without prior cast saw experience participated. Each completed cast removal on a cylindrical wax model before and after a standardized educational module. Models were casted with a consistent technique and mounted on a custom apparatus providing four discrete cutting lanes. After each session, investigators removed the cast material and quantified cast saw-related errors, including number, total length, maximum depth, and maximum width of wax deformities. Preinstruction and postinstruction results were compared within participants.

Participants demonstrated significant improvement after completing the educational module. Average errors per block decreased from 9.02 to 3.78; total error length decreased from 154.51 mm to 41.49 mm; maximum error depth decreased from 1.61 mm to 0.37 mm; and maximum error width decreased from 56.02 mm to 16.31 mm. All improvements were statistically significant.

A brief, structured cast saw training session using a validated wax simulation model markedly reduced both the frequency and severity of cast removal errors in novice learners. This simulation-based approach provides a standardized, low-cost alternative to traditional training methods, which are often resource-intensive and inconsistently implemented.

The proposed cast saw educational module improves cast removal safety and represents a cost-effective, time-efficient, scalable training tool suitable for orthopaedic residency programs and healthcare systems seeking to reduce cast-related complications.

(1)Simulation-Based Cast Saw Training: A validated wax-model simulation provides an effective, low-cost platform for teaching safe cast removal techniques.(2)Improved Safety Through Education: A brief, structured educational module significantly reduces cast saw-related errors among novice learners.(3)Standardization of Nonoperative Skills: Formalizing cast removal instruction addresses a critical gap in orthopaedic training, where non-operative skills often receive less emphasis.(4)Risk Reduction and Quality Improvement: Enhanced cast saw proficiency may decrease patient complications, medicolegal events, and healthcare utilization.(5)Feasibility and Scalability: The wax-based training model is reproducible, time-efficient, and easily implemented across orthopaedic training programs.

Level II.