Surgical Coaching from Head-Mounted Video in the Training of Fluoroscopically Guided Articular Fracture Surgery

Matthew D Karam; Geb W Thomas; Daniel M Koehler; Brian O Westerlind; Paul M Lafferty; Gary Thomas Ohrt; J Lawrence Marsh; Ann E Van Heest; Donald D Anderson

doi:10.2106/JBJS.N.00748

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Surgical Coaching from Head-Mounted Video in the Training of Fluoroscopically Guided Articular Fracture Surgery

Journal article

Peer reviewed

Surgical Coaching from Head-Mounted Video in the Training of Fluoroscopically Guided Articular Fracture Surgery

Matthew D Karam, Geb W Thomas, Daniel M Koehler, Brian O Westerlind, Paul M Lafferty, Gary Thomas Ohrt, J Lawrence Marsh, Ann E Van Heest and Donald D Anderson

Journal of bone and joint surgery. American volume, Vol.97(12), pp.1031-1039

06/17/2015

DOI: 10.2106/JBJS.N.00748

PMID: 26085538

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Abstract

The evolving surgical skills education paradigm in orthopaedics has generated a strong demand for validated educational tools and methodologies. This study aimed to confirm that a one-on-one faculty coaching review of the head-mounted video recording of a resident's surgical performance on a validated articular fracture simulation trainer would substantially improve subsequent performance. Fifteen first-year or second-year orthopaedic surgery residents reduced and fixed a standardized intra-articular tibial plafond fracture model under fluoroscopic guidance. Their performances were recorded by a head-mounted video camera. Prior to repeating the procedure six weeks later, eight subjects (the intervention group) reviewed the video of their performance with an orthopaedic traumatologist, and seven subjects (the control group) did not. Cohort performance was compared with respect to task duration, number of fluoroscopic images, and scores on the Objective Structured Assessment of Technical Skills (OSATS) as evaluated by fellowship-trained orthopaedic traumatologists blinded to the residents' year in training and prior surgical experience. The initial performance OSATS scores were not significantly different (p ≥ 0.05) between the control and intervention groups. Assessments of their repeat performance showed a significant net interval improvement (p < 0.05) in OSATS scores in the intervention group (mean [and standard deviation], 21 ± 8 points) compared with the control group (6 ± 3 points). The mean fluoroscopy utilization had a significant net decrease (p < 0.05) in the intervention group (-5.4 ± 11.7 points) compared with the control group (5.3 ± 7.0 points). Task duration in the repeat performance was similar between both groups. Personalized video-based feedback improved performance on a standardized articular fracture trainer for first-year and second-year residents. The described technique may further enhance resident surgical skills education.

Clinical Competence

Joints - injuries

Tibial Fractures - surgery

Video Recording - instrumentation

Humans

Joints - surgery

Surgery, Computer-Assisted - education

Surveys and Questionnaires

Fluoroscopy

Orthopedics - education

Education, Medical, Graduate - methods

Details

Title: Subtitle: Surgical Coaching from Head-Mounted Video in the Training of Fluoroscopically Guided Articular Fracture Surgery
Creators: Matthew D Karam - Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for M.D. Karam: matthew-karam@uiowa.edu. E-mail address for J.L. Marsh: j-marsh@uiowa.edu
Geb W Thomas - Department of Mechanical and Industrial Engineering, The University of Iowa, 3131 Seamans Center for the Engineering Arts and Sciences, Iowa City, IA 52242. E-mail address: geb-thomas@uiowa.edu
Daniel M Koehler - Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for M.D. Karam: matthew-karam@uiowa.edu. E-mail address for J.L. Marsh: j-marsh@uiowa.edu
Brian O Westerlind - Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for M.D. Karam: matthew-karam@uiowa.edu. E-mail address for J.L. Marsh: j-marsh@uiowa.edu
Paul M Lafferty - Department of Orthopaedic Surgery, University of Minnesota, 640 Jackson Street, St. Paul, MN 55101. E-mail address for P.M. Lafferty: PLaffMD@gmail.com. E-mail address for A.E. Van Heest: vanhe003@umn.edu
Gary Thomas Ohrt - Pacific Research Laboratories, 10221 Southwest 188th Street, PO Box 409, Vashon Island, WA 98070
J Lawrence Marsh - Department of Orthopaedics and Rehabilitation, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 01008 JPP, Iowa City, IA 52242. E-mail address for M.D. Karam: matthew-karam@uiowa.edu. E-mail address for J.L. Marsh: j-marsh@uiowa.edu
Ann E Van Heest - Department of Orthopaedic Surgery, University of Minnesota, 640 Jackson Street, St. Paul, MN 55101. E-mail address for P.M. Lafferty: PLaffMD@gmail.com. E-mail address for A.E. Van Heest: vanhe003@umn.edu
Donald D Anderson - Department of Orthopaedics and Rehabilitation, The University of Iowa, 2181 Westlawn Building, Iowa City, IA 52242. E-mail address: don-anderson@uiowa.edu
Resource Type: Journal article
Publication Details: Journal of bone and joint surgery. American volume, Vol.97(12), pp.1031-1039
DOI: 10.2106/JBJS.N.00748
PMID: 26085538
NLM abbreviation: J Bone Joint Surg Am
ISSN: 0021-9355
eISSN: 1535-1386
Publisher: Journal of Bone and Joint Surgery Incorporated; United States
Language: English
Date published: 06/17/2015
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
Record Identifier: 9984040284602771

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