Title: Transfer validity of paediatric supracondylar humeral fracture pin placement practice on in-theatre performance by orthopaedic trainees using an augmented reality simulator: Protocol for a non-randomized intervention cohort with retrospective comparator pilot study (Preprint)

Abstract

Supracondylar humeral fractures (SCHF) are a common cause of orthopaedic morbidity in paediatric populations across the world. The treatment of this fracture is likely one of the first procedures involving X-ray guided wire insertion that trainee orthopaedic surgeons will encounter in their career. Traditional surgical training methods of “see one, do one, teach one” are reliant on the presence of real-world cases and must be conducted within an operative environment. We have developed an augmented reality simulator that allows trainees to practice this procedure in a radiation-free environment at no extra risk to patients.

To examine whether training on a simulator in addition to traditional surgical training improves trainees’ in-theatre performance.

This multi-centre, interventional cohort study will involve New Zealand orthopaedic trainees in their first year of advanced training between 2019 – 2023. Advanced trainees with no simulator exposure who were first years in 2019 - 2021 will form the comparator cohort, while those in the years 2022 - 2023 will receive additional regular simulator training as the intervention cohort. The comparator cohort’s performance in paediatric SCHF surgery will be retrospectively audited using routinely collected operative outcomes and parameters over a six month period. The performance of the intervention cohorts will be collected in the same way over a comparable period. The data collected for both groups will be used to determine whether additional training with an augmented reality training shows improved real-world surgical outcomes compared to traditional surgical training.

As of February 2022, 8 retrospective comparator trainees have been recruited by email. The study is financially supported through an external grant from the Wishbone Orthopaedic Research Foundation of New Zealand (September 2021) and an internal research grant from the University of Otago (July 2021).

This protocol has been approved by the University of Otago Health Ethics committee, reference (HD21/087) and the study is ongoing. This protocol may assist other researchers conducting similar studies in the field.

U1111-1271-2730