Setting proficiency standards for simulation-based mastery learning of short antegrade femoral nail osteosynthesis: a multicenter study
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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.
Original language | English |
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Journal | Acta Orthopaedica |
Volume | 95 |
Pages (from-to) | 275-281 |
Number of pages | 7 |
ISSN | 1745-3674 |
DOIs | |
Publication status | Published - 2024 |
Bibliographical note
Publisher Copyright:
© 2024 The Author(s).
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