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Touch Surgery™: Analysis of Surgical Simulation Validity and Training Potential
Andrew Miller, MD1; Joseph T Labrum, BA2; Tulipan Jacob, MD1; Andrew G. Park, MD1; Asif I Ilyas, MD1
1Thomas Jefferson University Hospital, Philadelphia, PA; 2Sidney Kimmel Medical College, Philadelphia, PA

With recent limitations in post-graduate training hours and heightened focus on operating room efficiency and patient safety, there exists a need to supplement surgical education with surgical simulation. Touch Surgeryª is a smart device application that aims to provide a cognitive motor skill simulation and surgical step rehearsal based on technique and sequential steps that are hallmarks of a given surgical intervention. The aim of this study was to assess program validity, content authenticity, training potential, and user satisfaction of the Carpal Tunnel Surgery Phase 2: Carpal Tunnel Release Touch Surgeryª (CTR) module and the Tension Band Wire for Olecranon Fracture Touch Surgeryª (TBW) module. Eighteen novices, twelve intermediates and five experts were recruited to complete the CTR and TBW simulation modules. All participants with prior exposure to Touch Surgeryª were excluded. All participants carried out Touch Surgery module learn and test simulations in a standardized fashion (Figure 1). Participants completed the CTR and TBW modules 3 consecutive times. A performance score was generated after completing each module attempt. The novice cohort was given a 12-item likert questionnaire assessing both face validity and user satisfaction. The intermediate and expert cohorts completed a 15-item likert questionnaire, with additional items assessing content validity of the surgical simulations. Analysis of Variance (ANOVA) was used to evaluate for significant differences in the simulation module performance. All participants demonstrated improvement in all attempts for both modules (p< 0.05). Experts outperformed both intermediates and novices in both modules (Table 1). These results were significant for all modules (p< 0.05) except in the final two attempts of the TBW module. When combining novice and intermediate, expert results were significant for all attempts at the TBW module (p <0.05). All participants agreed on the utility for surgical training and learning new operations (Table 2). Both intermediates and experts agreed that the procedural steps were realistic. All participants agreed that the simulation module should be made available to all surgical trainees.All participants demonstrated improvement with their simulation module scores over all attempts. Comparatively, all experts demonstrated higher scores in all attempted modules for carpal tunnel release and tension band wiring. These results were significant (p < 0.05) for all module performances except for the second and third tension band wiring modules attempts. The results of this study demonstrate that Touch Surgeryª is a valid simulation for surgical procedures that may prove to be beneficial in orthopedic surgical training.




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