Background and Objectives: Freehand distal interlocking of intramedullary nails is technically
demanding and prone to handling issues. It requires precise placement of a screw through the nail
under fluoroscopy guidance and can result in a time consuming and radiation expensive procedure.
Dedicated training could help overcome these problems. The aim of this study was to assess construct
and face validity of new Digitally Enhanced Hands-On Surgical Training (DEHST) concept and
device for training of distal interlocking of intramedullary nails. Materials and Methods: Twenty-nine
novices and twenty-four expert surgeons performed interlocking on a DEHST device. Construct
validity was evaluated by comparing captured performance metrics—number of X-rays, nail hole
roundness, drill tip position and drill hole accuracy—between experts and novices. Face validity was
evaluated with a questionnaire concerning training potential and quality of simulated reality using
a 7-point Likert scale. Results: Face validity: mean realism of the training device was rated 6.3 (range
4–7). Training potential and need for distal interlocking training were both rated with a mean of
6.5 (range 5–7), with no significant differences between experts and novices, p 0.234. All participants
(100%) stated that the device is useful for procedural training of distal nail interlocking, 96% wanted
to have it at their institution and 98% would recommend it to colleagues. Construct validity: total
number of X-rays was significantly higher for novices (20.9 6.4 versus 15.5 5.3, p = 0.003). Success
rate (ratio of hit and miss attempts) was significantly higher for experts (novices hit: n = 15; 55.6%;
experts hit: n = 19; 83%, p = 0.040). Conclusion: The evaluated training device for distal interlocking of
intramedullary nails yielded high scores in terms of training capability and realism. Furthermore,
construct validity was proven by reliably discriminating between experts and novices. Participants
indicate high further training potential as the device may be easily adapted to other surgical tasks.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:89050 |
| Date | 16 January 2024 |
| Creators | Pastor, Torsten, Pastor, Tatjana, Kastner, Philipp, Souleiman, Firas, Knobe, Matthias, Gueorguiev, Boyko, Windolf, Markus, Buschbaum, Jan |
| Publisher | MDPI |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 773 |
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