TouchSurgery™: Analysis and Assessment of Validity of an Orthopedic Surgery Simulation "App"
Andrew Park, MD; Jacob Tulipan, MD; Andrew Miller, MD; Asif Ilyas, MD
Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, PA
Surgical training has been historically built upon extensive patient-based exposure in the operating room under the apprenticeship model. However, there is a growing need to supplement surgical education with surgical simulation. TouchSurgery™ is an interactive, free, smart device application that aims to provide a realistic, cognitive motor skill simulation and surgical step rehearsal based on technique and sequential steps that are hallmarks of a given surgical intervention.4 The primary aim of this study was to assess program validity, content authenticity, training potential using the Tension Band Wire for Olecranon Fracture Touch Surgery™ (TBW) module.
Eighteen novices, twelve intermediates and five experts were recruited to partiicpate. All participants with prior experience with Touch Surgery™ were excluded. After completing the training modules, all participants completed the TBW modules 3 consecutive times. All study participants carried out the study modules on standard iPad™ tablets to ensure a similar operating interface. The novice cohort was also given a 12-item likert questionnaire assessing both face validity of the Touch Surgery module and user satisfaction with the application. The intermediate and expert cohorts were surveyed with a 15-item likert questionnaire, with an additional 3 items assessing content validity of the surgical simulations. Descriptive statistics were performed.
All participants demonstrated improvement in all consecutive attempts (p< 0.05). Experts outperformed both intermediates and novices. When combining novice and intermediate, expert results were still significant for all attempts (p <0.05). All participants agreed on the utility of the app for surgical training and learning new operations. Both intermediates and experts agreed that the procedural steps were realistic. All participants agreed that the simulation module should be made available to all surgical trainees.
All participants demonstrated improvement with their simulation module scores over all attempts. Comparatively, all experts demonstrated higher scores in all attempted modules. The results of this study confirmed validity, reproducibility, and training potential with the TouchSurgery™ app as a valid simulation for surgical procedures that may benefit in the surgical training of medical students and residents in orthopedics.
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