Evaluation of a Novel Educational Three-Dimensionally-Printed, Unstable, Distal Radius Fracture Model for Reduction and Splinting.

Abstract

We conducted an initial orthopaedic resident-based evaluation of a novel three-dimensionally (3D) printed model simulating a displaced, unstable distal radius fracture (DRF). We hypothesized the model would have construct validity, enhance beginner resident performance when used for teaching, and be rated as beneficial. Thirty-three residents across all postgraduate years (PGY) from multiple institutions participated. We gathered baseline clinical DRF experience levels for each through Accreditation Council for Graduate Medical Education case logs. We block randomized 14 PGY-1 residents into two groups: no exposure versus formal teaching with the model before testing. All other residents carried out testing without prior exposure. All PGY residents completed a single model testing session including reduction, splinting, and fluoroscopy, with standardized performance assessments by a board-certified hand surgery fellowship-trained orthopaedic surgeon. Performance metrics for each session included a global rating scale (GRS), an objective structured assessment of technical skills, reduction/splinting time, final radiographic sagittal tilt, and a DRF written examination. We also gathered anonymous feedback on the model. PGY-1 residents taught with the model scored markedly better per GRS (P < 0.05). No notable differences were found between the randomized PGY-1 groups for the objective structured assessment of technical skills, procedure times, or examinations (P > 0.05). PGY-1 residents with no prior exposure had markedly longer group-level procedure times than all other PGY residents with no prior exposure, supporting construct validity for the model (P < 0.05). Furthermore, PGY level markedly correlated with better GRS and examination scores and procedure times (P < 0.05). Baseline DRF experience was also markedly associated with better GRS scores (P < 0.05). Anonymous resident feedback indicated that they would recommend the 3D-printed DRF models to improve education. Our 3D-printed unstable DRF model demonstrated construct validity across multiple domains. PGY-1 residents taught with the model scored better on the GRS, suggesting potential improved skill acquisition and assessment. All PGY residents recommended the models for DRF education.