A Prospective, Randomized, Blinded Trial Comparing Digital Simulation to Textbook for Cleft Surgery Education

Abstract

Background: Simulation is progressively being integrated into surgical training; however, its utility in plastic surgery has not been well described. The authors present a prospective, randomized, blinded trial comparing digital simulation to a surgical textbook for conceptualization of cleft lip repair. Methods: Thirty-five medical students were randomized to learning cleft repair using a simulator or a textbook. Participants outlined markings for a standard cleft lip repair before (preintervention) and after (postintervention) 20 minutes of studying their respective resource. Two expert reviewers blindly graded markings according to a 10-point scale, on two separate occasions. Intrarater and interrater reliability were calculated using intraclass correlation coefficients. Paired and independent t tests were performed to compare scoring between study groups. A validated student satisfaction survey was administered to assess the two resources separately. Results: Intrarater grading reliability was excellent for both raters for preintervention and postintervention grading (rater 1, intraclass correlation coefficient = 0.94 and 0.95, respectively; rater 2, intraclass correlation coefficient = 0.60 and 0.92, respectively; p < 0.001). Mean preintervention performances for both groups were comparable (0.82 ± 1.17 versus 0.64 ± 0.95; p = 0.31). Significant improvement from preintervention to postintervention performance was observed in the textbook (0.82 ± 1.17 versus 3.50 ± 1.62; p < 0.001) and simulator (0.64 ± 0.95 versus 6.44 ± 2.03; p < 0.001) groups. However, the simulator group demonstrated a significantly greater improvement (5.81 ± 2.01 versus 2.68 ± 1.49; p < 0.001). Participants reported the simulator to be more effective (p < 0.001) and a clearer tool (p < 0.001), that allowed better learning (p < 0.001) than textbooks. All participants would recommend the simulator to others. Conclusion: The authors present evidence from a prospective, randomized, blinded trial supporting online digital simulation as a superior educational resource for novice learners, compared with traditional textbooks.

Aesthetic Training in Plastic Surgery Residency

“… 4 , 7 , 8 This focal deficit is likely due, at least in part, to a more complicated operating process and the highly sensitive and visible nature of facial outcomes. 33 , 34 In addition, the ACGME-mandated minimum number of nonsurgical cases, namely botulinum toxin injections and dermal fillers, have been difficult to reach for many residents. 30 Although these procedures should be performed with less time commitment and training than with more complex surgeries, residents are suffering from a lack of confidence and a suboptimal level of patient demand, which makes gaining experience difficult.…”

“… 31 , 32 In addition, studies have shown that simulation-based training produces more significant increases in both knowledge and skill when compared with more traditional educational methods, including self-directed reading and the use of digital images. 33 , 34 Simulation training includes use of cadavers, animal models, and prosthetic devices. Simulation training has been used in other subspecialties of plastic surgery, most notably with animal models for microsurgical vessel anastomosis training and human cadaver models for popular flap reconstruction courses.…”

Computational technology for nasal cartilage-related clinical research and application

“…In recent years, the technology has been further developed, yielding digital simulations involved in human-computer interactions, which enabled students to study each surgical step in great detail. [132][133][134] Each step of cleft lip nasal deformity reconstruction was listed. The students and doctors can choose the step they want to learn and view the manoeuvre from different angles.…”

Use of Simulation in Plastic Surgery Training

“… 5 , 7 Finally, use of simulation has been shown to yield greater increases in knowledge and skill compared to using traditional educational methods, such as self-directed reading and use of digital images. 9 …”