Comparing Feedback Techniques in Bilobe Flap Simulation Using 3D‐Printed Facial Models

Abstract

ObjectiveTo compare live versus delayed feedback on trainee performance of bilobe flaps using 3‐dimensional (3D)‐printed facial simulators and determine whether these effects are sustained on repeat performance.Study DesignCohort study.SettingUniversity of Arkansas for Medical Sciences.Methods3D‐printed facial models with a nasal ala defect were provided to 18 subjects. Subjects were stratified and randomized based on their training level into 1 of 3 groups corresponding to live feedback (Group 1), delayed feedback (Group 2), and no feedback (Group 3). Subjects performed a bilobe flap following a structured lecture. Four weeks later, subjects independently repeated the exercise on the contralateral ala. Likert surveys were used to assess subjective parameters. Objective grading was performed by a plastic surgeon, which included a point system and score for the overall appearance.ResultsFollowing exercise 1, Group 1 reported a significant improvement in knowledge (P < .001), which was sustained after exercise 2 (P < .001); Group 2 reported a significant improvement after exercise 1 (P = .03) but was not sustained (P = .435). After the second exercise, Group 1 and Group 2 improved their confidence in bilobed repair (P = .001 and P = .003, respectively), but this was greater for Group 1. Group 1 showed a significant improvement in their design time following exercise 2 (P = .007). There were no significant differences between groups on total time for repair, total score, and appearance.Conclusion3D‐printed models are valuable in teaching the bilobe flap for nasal defects, with live feedback providing the greatest level of improvement in self‐reported knowledge and confidence.