Orthopaedic Resident Preparedness for Closed Reduction and Pinning of Pediatric Supracondylar Fractures Is Improved by e-Learning A Multisite Randomized Controlled Study

被引:26
作者
Hearty, Thomas
Maizels, Max
Pring, Maya
Mazur, John
Liu, Raymond
Sarwark, John
Janicki, Joseph
机构
[1] U.S. Naval Hospital Okinawa, FPO, AP 96362, PSC 482
[2] Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611
[3] Rady Children's Hospital San Diego, San Diego, CA 92123
[4] Nemours Children's Clinic, Jacksonville, FL 32207
[5] University Hospitals Rainbow Babies, Children's Hospital, Cleveland, OH 44106, 11100 Euclid Avenue
关键词
D O I
10.2106/JBJS.L.01065
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: There is a need to provide more efficient surgical training methods for orthopaedic residents. E-learning could possibly increase resident surgical preparedness, confidence, and comfort for surgery. Using closed reduction and pinning of pediatric supracondylar humeral fractures as the index case, we hypothesized that e-learning could increase resident knowledge acquisition for case preparation in the operating room. Methods: An e-learning surgical training module was created on the Computer Enhanced Visual Learning platform. The module provides a detailed and focused road map of the procedure utilizing a multimedia format. A multisite prospective randomized controlled study design compared residents who used a textbook for case preparation (control group) with residents who used the same textbook plus completed the e-learning module (test group). All subjects completed a sixty-question test on the theory and methods of the case. After completion of the test, the control group then completed the module as well. All subjects were surveyed on their opinion regarding the effectiveness of the module after performing an actual surgical case. Results: Twenty-eight subjects with no previous experience in this surgery were enrolled at four academic centers. Subjects were randomized into two equal groups. The test group scored significantly better (p < 0.001) and demonstrated competence on the test compared with the control group; the mean correct test score (and standard deviation) was 90.9% +/- 6.8% for the test group and 73.5% +/- 6.4% for the control group. All residents surveyed (n = 27) agreed that the module is a useful supplement to traditional methods for case preparation and twenty-two of twenty-seven residents agreed that it reduced their anxiety during the case and improved their attention to surgical detail. Conclusions: E-learning using the Computer Enhanced Visual Learning platform significantly improved preparedness, confidence, and comfort with percutaneous closed reduction and pinning of a pediatric supracondylar humeral fracture. We believe that adapting such methods into residency training programs will improve efficiency in surgical training.
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页码:1630 / +
页数:2
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