TY - JOUR
T1 - Standardized Schematics for Facial Trauma Planning
T2 - A Clinical Education Tool
AU - De Ruiter, Brandon J.
AU - Lesko, Robert P.
AU - Davidson, Edward H.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - INTRODUCTION: Learning facial fracture management principles can be challenging for surgical trainees. Residents must assimilate nuances of fixation techniques, skeletal biomechanics, and hardware use while managing acute work-flow limitations. This study aims to design a standardized-schematic for teaching facial fracture management and evaluate its performance improving resident operative planning. METHODS: Printable schematics of the facial skeleton with soft-tissue overlay were developed. Instructions on depicting fracture pattern, incisions, plating sequence, loadbearing/sharing plates, locking/nonlocking screws, and mono/bicortical screws were given. Senior residents (n=5) evaluated computed tomography of 3 mandibular fractures and submitted 3 operative plans per case: first without guidance, then with written instruction, and finally using the schematic (n=45). Performance was graded on content and conceptual correctness. Data on time to completion was obtained. Likert-scale surveys assessing understanding, communication, and operative planning were given RESULTS:: Schematic use improved operative plan content and facilitated communication of resident operative schemes. Of 7 content domains spanning approach, plating strategy, and screw selection, a mean of 2.3, 3.7, and 6.5 were included with no guidance, written instruction, and schematic use respectively. Information on approach (P=0.001), plating type (P=0.02), screw location (P<0.000), screw depth (P=0.000), and screw locking status (P=0.000) were improved when comparing pre- and postintervention plans. Mean time to completion was 8 minutes and 54 seconds. All subjects "agreed" (n=2) or "strongly agreed" (n=3) that schematic use aided planning and communication. CONCLUSIONS: Simple, guided interventions can enhance surgical training by identifying knowledge gaps, improving visuospatial conceptualization, and facilitating targeted discussions with attendings.
AB - INTRODUCTION: Learning facial fracture management principles can be challenging for surgical trainees. Residents must assimilate nuances of fixation techniques, skeletal biomechanics, and hardware use while managing acute work-flow limitations. This study aims to design a standardized-schematic for teaching facial fracture management and evaluate its performance improving resident operative planning. METHODS: Printable schematics of the facial skeleton with soft-tissue overlay were developed. Instructions on depicting fracture pattern, incisions, plating sequence, loadbearing/sharing plates, locking/nonlocking screws, and mono/bicortical screws were given. Senior residents (n=5) evaluated computed tomography of 3 mandibular fractures and submitted 3 operative plans per case: first without guidance, then with written instruction, and finally using the schematic (n=45). Performance was graded on content and conceptual correctness. Data on time to completion was obtained. Likert-scale surveys assessing understanding, communication, and operative planning were given RESULTS:: Schematic use improved operative plan content and facilitated communication of resident operative schemes. Of 7 content domains spanning approach, plating strategy, and screw selection, a mean of 2.3, 3.7, and 6.5 were included with no guidance, written instruction, and schematic use respectively. Information on approach (P=0.001), plating type (P=0.02), screw location (P<0.000), screw depth (P=0.000), and screw locking status (P=0.000) were improved when comparing pre- and postintervention plans. Mean time to completion was 8 minutes and 54 seconds. All subjects "agreed" (n=2) or "strongly agreed" (n=3) that schematic use aided planning and communication. CONCLUSIONS: Simple, guided interventions can enhance surgical training by identifying knowledge gaps, improving visuospatial conceptualization, and facilitating targeted discussions with attendings.
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U2 - 10.1097/SCS.0000000000006575
DO - 10.1097/SCS.0000000000006575
M3 - Article
C2 - 32569037
AN - SCOPUS:85088210450
SN - 1049-2275
VL - 31
SP - 1297
EP - 1300
JO - The Journal of craniofacial surgery
JF - The Journal of craniofacial surgery
IS - 5
ER -