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Implementation of a Simulation-Based Cast Saw Technique Educational Module to Improve Cast Removal Safety
Nithya Lingampalli1, Elizabeth Cho1, Nicolas Jozefowski1
1Loyola University Medical Center, Maywood, IL, USA.
Journal of the Pediatric Orthopaedic Society of North America
|August 14, 2026
Summary
A new wax-model simulation effectively trains novice learners in safe cast saw removal, significantly reducing errors. This cost-effective method enhances patient safety and addresses gaps in orthopaedic nonoperative skills training.
Area of Science:
- Orthopaedic Surgery
- Medical Education
- Simulation-Based Training
Background:
- Nonoperative skills, including safe cast removal, are insufficiently taught in orthopaedic residency.
- Improper cast saw technique poses risks like burns, abrasions, and medicolegal issues.
- Traditional training methods are resource-intensive, limiting widespread adoption.
Purpose of the Study:
- To evaluate the effectiveness of a structured cast saw training module using a validated wax simulation model.
- To assess the impact of this training on novice learners' cast removal skills.
- To provide a cost-effective and reproducible method for cast saw safety training.
Main Methods:
- 42 medical students without prior cast saw experience participated.
- Each student performed cast removal on a wax model before and after a standardized educational module.
- Cast saw errors (number, length, depth, width) were quantified and compared pre- and post-training.
Main Results:
- Significant reductions in cast saw errors were observed post-training.
- Average errors per block decreased from 9.02 to 3.78.
- Total error length, maximum depth, and maximum width also significantly decreased.
Conclusions:
- A brief, structured cast saw training session using wax simulation markedly reduced errors in novice learners.
- This simulation-based approach offers a standardized, low-cost alternative to traditional training.
- The module improves cast removal safety and is a scalable training tool for residency programs.