Impact of a three-dimensional "hands-on" anatomic teaching module on acetabular fracture pattern recognition by orthopaedic residents.

Abstract

Much of the difficulty in understanding acetabular fracture patterns is due to the complex three-dimensional relationship of the acetabulum to the greater pelvis. We hypothesized that combining three-dimensional "hands-on" anatomic models with two-dimensional informational teaching sheets would improve the ability of orthopaedic residents to accurately classify acetabular fracture patterns and aid in preoperative surgical approach selection. Thirty-five orthopaedic residents from two programs accredited by the Accreditation Council for Graduate Medical Education participated in this prospective study. Twenty-question quizzes based on radiographs and computed tomography images of acetabular fractures tested the ability of the residents to accurately classify these fractures. One-half of the residents had access to informational teaching sheets only, and the other group had access to three-dimensional pelvic models of the fractures in addition to the informational sheets. There was a positive correlation between the postgraduate year in training and the mean pre-intervention quiz score (r2 = 0.89). The mean improvement in the quiz score was 15% ± 15% for first and second-year residents compared with 3% ± 12% for fourth and fifth-year residents (p = 0.04). The resident group that used the three-dimensional "hands-on" models showed greater post-intervention improvement in the quiz score. In this preliminary study, active learning that incorporated three-dimensional "hands-on" pelvic models improved the ability of orthopaedic residents to accurately classify acetabular fracture patterns compared with use of informational teaching sheets alone.