Development and Preliminary Validation of a Tactile, 3D-Printed Kirschner Wire Pinning Simulator for Orthopaedic Surgery Residents.

Abstract

There are limited opportunities for orthopaedic trainees to practice placing Kirschner wires for fracture fixation outside the operating room. We created an inexpensive, low-fidelity simulator to meet this need. The simulator is composed of a bone model, soft-tissue model, light fixture "radiograph," and an electronic component and costs US$53. Validation evidence relevant to test content was evaluated by five fellowship-trained pediatric orthopaedic surgeons using a Likert scale to assess the physical characteristics of the models and their ability to result in transfer of skills to the operating room. Model 3 had the highest average score for feel of the near (3.4) and far (3.4) cortex. Model 2 had the highest average score for feel of the medullary canal (3.2) and pin visualization (2.6). The simulator had high scores for ease of use and implementation and was rated highly for its ability to support residents' learning to triangulate to a defined target (4.8) and improve motor skills (4.4). We were able to create an inexpensive, low-fidelity simulator with potential for high transferability, which can be used by orthopaedic surgery residents to improve their motor skills in a low risk, high-reward environment.