Improving Patient Safety in Orthopaedic Trauma Surgical Training

提高骨科创伤手术培训中的患者安全

基本信息

批准号：
8742427
负责人：
Donald D Anderson
金额：
$ 73.99万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-01 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8742427
关键词：
Improving Patient Safety Orthopaedic Trauma

项目摘要

Project Summary / Abstract Orthopaedic surgical skills are largely acquired through apprenticeship in the operating room (OR). This expensive and unforgiving training model struggles to ensure patient safety. The long-term goal of this work is to improve patient safety and outcomes by providing effective simulation tools. The work is significant in that it will provide rigorous scientific evidence that a surgical simulator can improve an orthopaedic resident's OR performance. A common and important skill that orthopaedic residents learn is to drive a sharpened stainless steel pin along a precise path within bone. This task, commonly called wire navigation, is a part of treating many common fractures. The task requires surgeons to rely on 2D fluoroscopic imaging to assess progress of the wire within the bone. Precisely controlling the position of the wire is critical to patient safety and fixation strength. A simulator has been developed to mimic wire navigation in one of the most common surgeries in orthopaedics: the fixing of a fracture of the proximal femur. The augmented reality simulator blends a real drill and surrogate femur with computer-generated fluoroscopic images. The simulator closely replicates the sensation of drilling in the OR while retaining the benefit of a radiation-free training environment. Task performance is assessed upon completion by measuring several important quantities, which can likewise be directly measured in the OR. The specific objective of the proposed research is to measure the effectiveness of using the new simulator to train residents in wire navigation. The central hypothesis is that the simulator reproduces critical elements of actual wire navigation. The following aims will be pursued. Aim 1: Demonstrate how deliberate practice improves wire navigation performance. Multi-institutional studies involving nearly 300 orthopaedic residents will be undertaken to measure the learning curve for acquiring wire navigation skill on the radiation-free simulator. Prior to progressing to the OR, studies will be conducted to show that simulator performance improves performance on a surgical simulation involving actual fluoroscopy. Aim 2: Show that simulator performance correlates with performance in the OR. Additional studies will be conducted to demonstrate that skill assessments with the simulator distinguish junior orthopaedic residents from senior residents. Additional studies will be conducted to determine if performance on the simulator correlates with OR performance. The proposed series of studies link training and assessment in the skills lab to performance in the OR. This paves the way for developing, testing, and improving simulators within orthopaedic surgery. An experienced research team has been assembled, and a commercial partner is ready to foster wider dissemination of the simulator. Increased resident skill in wire navigation gained outside of the OR will spare patients unnecessary additional risk, lead to faster procedures, yield better surgical results, and ultimately provide better patient outcomes.

项目摘要 /摘要骨科手术技能主要是通过手术室（OR）的学徒获得的。这种昂贵且无情的培训模式为确保患者的安全而努力。长期目标这项工作是通过提供有效的模拟工具来提高患者的安全和结果。工作重要的是，它将提供严格的科学证据，表明手术模拟器可以改善骨科居民或性能。骨科居民学习的一种常见和重要技能是沿着骨头内的精确路径驱动锐化的不锈钢销。这个任务，通常称为电线导航是治疗许多常见骨折的一部分。该任务要求外科医生依靠2D 荧光成像以评估骨头内电线的进度。精确控制电线对于患者的安全和固定强度至关重要。已经开发了模拟器以模仿电线在骨科中最常见的手术之一中导航：固定近端的断裂股骨。增强现实模拟器将真实的演习和股骨与计算机生成荧光镜图像。模拟器在保留时密切复制钻孔的感觉无辐射训练环境的好处。完成后完成任务绩效测量几个重要数量，同样可以直接在OR中进行测量。拟议研究的具体目标是衡量使用新的模拟器训练居民进行电线导航。中心假设是模拟器繁殖实际导航的关键要素。将追求以下目标。目标1：演示如何故意练习改善了电线导航性能。多机构研究几乎涉及将进行300个骨科居民以测量获得电线的学习曲线无辐射模拟器的导航技能。在进行OR之前，将进行研究为了证明模拟器性能改善了涉及实际的手术模拟的性能透视。 AIM 2：证明模拟器性能与OR中的性能相关。额外的将进行研究以证明使用模拟器区分初级的技能评估高级居民的骨科居民。将进行其他研究以确定是否模拟器上的性能与或性能相关。提出的一系列研究链接在技能实验室中培训和评估或在OR中的表现。这为发展铺平了道路测试并改善骨科手术中的模拟器。经验丰富的研究团队已经组装，商业合作伙伴准备促进模拟器的更广泛传播。增加在OR之外获得的电线导航的居民技能将使患者不必要的额外风险，导致程序更快，产生更好的手术结果，并最终提供更好的患者预后。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Assessing Wire Navigation Performance in the Operating Room.

评估手术室中的有线导航性能。

DOI：
10.1016/j.jsurg.2016.03.018
发表时间：
2016
期刊：
Journal of surgical education
影响因子：
2.9
作者：
Taylor,LeahK;Thomas,GebW;Karam,MatthewD;Kreiter,ClarenceD;Anderson,DonaldD
通讯作者：
Anderson,DonaldD

Skill Assessment in the Interpretation of 3D Fracture Patterns from Radiographs.

从射线照片解释 3D 骨折模式的技能评估。

DOI：
发表时间：
2016
期刊：
The Iowa orthopaedic journal
影响因子：
0
作者：
Thomas,GebW;Rojas-Murillo,Salvador;Hanley,JessicaM;Kreiter,ClarenceD;Karam,MatthewD;Anderson,DonaldD
通讯作者：
Anderson,DonaldD

Designing an Affordable Wire Navigation Surgical Simulator.

设计经济实惠的有线导航手术模拟器。