Effectiveness of a Low Fidelity Cast Removal Module in Orthopaedic Surgical Simulation

• Published in: Journal of surgical education 2018-09, Vol.75 (5), p.1329-1332
• Main Authors: Ruder, John A., Brighton, Brian K., Vander Have, Kelly L., Turvey, Blake R., Hsu, Joseph R., Scannell, Brian P.
• Format: Article
• Language: English
• Subjects: cast removal; cast saw burn; Interpersonal and Communication Skills; Patient Care; Practice-Based Learning and Improvement; resident education; surgical simulation
• ISSN: 1931-7204; 1878-7452
• DOI: 10.1016/j.jsurg.2018.01.020

The purpose of this study is to determine if an educational model during a surgical skills laboratory results in a significant reduction in cast saw blade temperatures generated during cast removal. As part of an orthopedic resident surgical skills laboratory an Institutional Review Board-approved study was performed. A total of 17 study subjects applied a short arm cast. Everyone removed 1 short arm cast with temperatures recorded on the saw blade. Following cast removal, an educational session was conducted on proper cast removal and blade cooling techniques. Everyone then removed a second cast. Blade temperatures were recorded. To assess reproducibility, the 5 PGY-1 orthopedic residents removed a short arm cast 3 months later. Carolinas Medical Center, Charlotte, NC, tertiary care center A total of 17 study subjects with minimal casting experience (5 PGY-1 orthopedic residents and 12 senior medical students) applied a short arm cast. Following the educational session there was a significant reduction in mean and mean maximum blade temperatures (p < 0.05). During the second round of cast removal assessment of blade temperatures and specific techniques to cool the blade were observed among all participants. At 3 months′ time, the mean and mean maximum blade temperatures remained significantly lower than before the educational session (p < 0.05). The intervention in this study reduced the maximum blade temperatures to levels below the threshold known to cause burns. This simple, low cost, and easily reproducible model can easily be disseminated across institutions and simulation laboratories.