3D Printing of Customizable Phantoms to Replace Cadaveric Models in Upper Extremity Surgical Residency Training.

Medical phantoms are commonly used for training and skill demonstration of surgical procedures without exposing a patient to unnecessary risk. The discrimination of these tissues is critical to the ability of young orthopedic surgical trainees to identify patient injuries and properly manipulate surrounding tissues into healing-compliant positions. Most commercial phantoms lack anatomical specificity and use materials that inadequately attempt to mimic human tissue characteristics. This paper covers the manufacturing methods used to create novel, higher fidelity surgical training phantoms. We utilize medical scans and 3D printing techniques to create upper extremity phantoms that replicate both osseous and synovial geometries. These phantoms are undergoing validation through OSATS training of surgical residents under the guidance of attendings and chief residents. Twenty upper extremity phantoms with distal radius fracture were placed into traction and reduced by first- and second-year surgical residency students as part of their upper extremity triage training. Trainees reported uniform support for the training, enjoying the active learning exercise and expressing willingness for participation in future trials. Trainees successfully completed the reduction procedure utilizing tactile stimuli and prior lecture knowledge, showing the viability of synthetic phantoms to be used in lieu of traditional cadaveric models.

High-Fidelity Wrist Fracture Phantom as a Training Tool to Develop Competency in Orthopaedic Surgical Trainees.

BACKGROUND: This article will describe the development of a low-cost 3D-printed medical phantom of the arm with a distal radius fracture (DRF) to facilitate training of reduction and splinting techniques. The phantom incorporates tactile responses and visual stimuli from fluoroscopy to assist skill acquisition in a clinical setting. This provides feedback to trainees to help them develop competency and knowledge before providing care to patients. METHODS: Phantoms were developed through advice and feedback from fellowship-trained hand surgeons and orthopaedic senior and junior residents. Phantoms were then pilot tested during a surgical skills examination, with residents having minimal previous exposure to distal radial reduction techniques. Residents were evaluated on procedure speed and accuracy by attending surgeons using the objective structured assessment of technical skills. Residents then completed a written knowledge examination about relevant requirements of DRF management and feedback on their opinion of the exercise using the Likert scale. RESULTS: Residents who passed the hands-on examination also scored higher on the written examination. All residents reported that the phantom was beneficial and motivating as part of their overall training. DISCUSSION: Real-time feedback using a phantom limb and fluoroscopic imaging, in conjunction with guidance from surgeons, allows residents to learn and practice DRF reduction and splinting techniques. These educational exercises are relatively low-cost and remove the risk of potential harm to patients during early skill acquisition. This training method may be a predictor of surgical performance in addition to providing assessment of background knowledge. Additional training sessions will be required to determine the effect of repeat exposure to residents' proficiency and comprehension.