TY - JOUR

T1 - Setting proficiency standards for simulation-based mastery learning of short antegrade femoral nail osteosynthesis

T2 - a multicenter study

AU - Gustafsson, Amandus

AU - Rölfing, Jan D.

AU - Palm, Henrik

AU - Viberg, Bjarke

AU - Grimstrup, Søren

AU - Konge, Lars

N1 - Publisher Copyright: © 2024 The Author(s).

PY - 2024

Y1 - 2024

N2 - Background and purpose — Orthopedic trainees fre-quently perform short antegrade femoral nail osteosynthesis of trochanteric fractures, but virtual reality simulation-based training (SBT) with haptic feedback has been unavailable. We explored a novel simulator, with the aim of gathering validity evidence for an embedded test and setting a credible pass/fail standard allowing trainees to practice to proficiency. Patients and methods — The research, conducted from May to September 2020 across 3 Danish simulation centers, utilized the Swemac TraumaVision simulator for short ante-grade femoral nail osteosynthesis. The validation process adhered to Messick’s framework, covering all 5 sources of validity evidence. Participants included novice groups, cate-gorized by training to plateau (n = 14) or to mastery (n = 10), and experts (n = 9), focusing on their performance metrics and training duration. Results — The novices in the plateau group and experts had hands-on training for 77 (95% confidence interval [CI] 59–95) and 52 (CI 36–69) minutes while the plateau test score, defined as the average of the last 4 scores, was 75% (CI 65–86) and 96% (CI 94–98) respectively. The pass/fail standard was established at the average expert plateau test score of 96%. All novices in the mastery group could meet this standard and interestingly without increased hands-on training time (65 [CI 46–84] minutes). Conclusion — Our study provides supporting validity evidence from all sources of Messick’s framework for a simulation-based test in short antegrade nail osteosynthesis of intertrochanteric hip fracture and establishes a defensible pass/fail standard for mastery learning of SBT. Novices who practiced using mastery learning were able to reach the pre-defined pass/fail standard and outperformed novices without a set goal for external motivation.

AB - Background and purpose — Orthopedic trainees fre-quently perform short antegrade femoral nail osteosynthesis of trochanteric fractures, but virtual reality simulation-based training (SBT) with haptic feedback has been unavailable. We explored a novel simulator, with the aim of gathering validity evidence for an embedded test and setting a credible pass/fail standard allowing trainees to practice to proficiency. Patients and methods — The research, conducted from May to September 2020 across 3 Danish simulation centers, utilized the Swemac TraumaVision simulator for short ante-grade femoral nail osteosynthesis. The validation process adhered to Messick’s framework, covering all 5 sources of validity evidence. Participants included novice groups, cate-gorized by training to plateau (n = 14) or to mastery (n = 10), and experts (n = 9), focusing on their performance metrics and training duration. Results — The novices in the plateau group and experts had hands-on training for 77 (95% confidence interval [CI] 59–95) and 52 (CI 36–69) minutes while the plateau test score, defined as the average of the last 4 scores, was 75% (CI 65–86) and 96% (CI 94–98) respectively. The pass/fail standard was established at the average expert plateau test score of 96%. All novices in the mastery group could meet this standard and interestingly without increased hands-on training time (65 [CI 46–84] minutes). Conclusion — Our study provides supporting validity evidence from all sources of Messick’s framework for a simulation-based test in short antegrade nail osteosynthesis of intertrochanteric hip fracture and establishes a defensible pass/fail standard for mastery learning of SBT. Novices who practiced using mastery learning were able to reach the pre-defined pass/fail standard and outperformed novices without a set goal for external motivation.

U2 - 10.2340/17453674.2024.40812

DO - 10.2340/17453674.2024.40812

M3 - Journal article

C2 - 38819402

AN - SCOPUS:85196316075

VL - 95

SP - 275

EP - 281

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

ER -