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Procedural simulation training in orthopaedics and traumatology: Nationwide survey among surgeon educators and residents in France - 25/11/22

Doi : 10.1016/j.otsr.2022.103347 
Charlie Bouthors a, , 1 , Louis Dagneaux b, Stéphane Boisgard c, Christian Garreau de Loubresse d, Dan Benhamou e, Charles Court a
a Université Paris-Saclay, AP–HP, hôpital Bicêtre, service de chirurgie orthopédique et Traumatologique, centre de simulation LabForSIMS, unité de recherche CIAMS EA4532, UFR STAPS, Paris Saclay, Orsay, France 
b Université de Montpellier, hôpital Lapeyronie, département de chirurgie orthopédique et traumatologique, CHU Montpellier, Montpellier, France 
c Université Clermont-Auvergne, CHU Clermont-Ferrand, CNRS, SIGMA Clermont, ICCF, Clermont-Ferrand, France 
d Université Paris V, AP–HP, hôpital Européen Georges Pompidou, service de chirurgie orthopédique et traumatologique, Paris, France 
e Université Paris-Saclay, AP–HP, hôpital Bicêtre, service d’Anesthésie - réanimation, centre de simulation LabForsIMS, unité de recherche CIAMS EA4532, UFR STAPS, Paris Saclay, Orsay, France 

Corresponding author at: Service de Chirurgie Orthopédique et Traumatologique, Hôpital Bicêtre, AP-HP, 78, rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France.Service de Chirurgie Orthopédique et Traumatologique, Hôpital Bicêtre, AP-HP78, rue du Général LeclercLe Kremlin Bicêtre94270France

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Abstract

Background

Simulation is among the tools used in France to train residents specialising in orthopaedic and trauma surgery (OTS). However, implementing simulation-based training (SBT) is complex and poorly reported. The objective of this study was to describe the use of simulation for OTS training in France.

Hypothesis

Nationwide, SBT is not used to its full capacity for teaching OTS in France, and differences in opinions about SBT may exist between surgeon educators and residents.

Study design

Nationwide questionnaire survey in France.

Materials and Methods

We built two specific self-questionnaires then e-mailed them between December 2020 and February 2021 to the surgeon educators who were members of the national university council and to the residents specialising in OTS during the current academic year. The questions were about the 2018–2019 academic year, before the COVID-19 pandemic. Two classes of residents who were still medical students during this period were not included, leaving three classes for the analysis.

Results

The participation rates were 57% (67/117) for the educators and 24% (87/369) for the three classes of residents. Of the 67 educators, 47 (70%) reported being involved in SBT and identified the university (70%) and industry (53%) as the main funders of this teaching modality. The educators indicated that the mean number of SBT laboratories in their region was 1.4±0.9 (range, 0–4). The main types of simulators were saw bones (77%); cadavers (85%); and commercial simulators (74%), notably for the knee (87%) and shoulder (78%). The educators estimated that they had achieved a mean of 33%±23% (range, 0%–100%) of the teaching objectives set out in the OTS curriculum and that the main obstacles were insufficient funding (81%) and lack of time (67%). Only 21% of educators reported conducting SBT research. The residents reported that they accessed SBT via the OTS teaching module (28/87, 32%), local university degrees (23/87, 26%), their hospital department (17/87, 18%), or the industry (15/87, 17%); 25/87 (29%) had never received SBT. On a 0–10 scale (0, completely disagrees; 10, completely agrees), the mean score for SBT effectiveness was 8.6±2.1 for residents and 7.1±3.0 for educators (p<0.001); the corresponding values for the quality of SBT integration in the region were 1.5±1.8 and 3.8±2.6, respectively (p<0.001).

Conclusion

SBT is not yet used to its full potential for teaching OTS in France. Insufficient funding and lack of time were identified by the educators as the main obstacles to greater use of SBT. Both the residents and the educators felt that SBT mightbe beneficial for training.

Level of evidence

IV, nationwide survey.

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Keywords : Simulation, Education, Training, Assessment, Orthopedic surgery, Survey


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Vol 108 - N° 8

Article 103347- décembre 2022 Retour au numéro
Article précédent Article précédent
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