Plaster cast removal simulation model for resident training.

Abstract

Purpose: Complications from cast removal are infrequent but can cause permanent skin sequelae. Formal training in cast removal is limited during residency. This study aimed to develop a plaster cast removal simulation model for resident training.

Methods: Quasiexperimental study. A pediatric forearm phantom with temperature sensors was designed to simulate forearm cast removal. Six first-year orthopedic residents with no prior cast removal experience and two experts were evaluated. The residents underwent an initial evaluation, followed by an instruction session, and a final evaluation. Performance was assessed using a specific ratings scale (SRS), the Objective Structured Assessment of Technical Skills (OSATS) guideline, procedure time, and temperature measurement. Median scores with ranges were reported, and pre- and posttraining performances were compared using the Wilcoxon test. Experts scores were compared with resident scores using the Mann-Whitney test. The statistical significance was set at p<0.05.

Results: Significant improvements in OSATS [(pre 22 points (range: 20-24); posttraining 25 (range: 25-28) (p=0.03)] and SRS [pre 8.5 points (range: 7-9); post 10 points (range: 8-10) (p=0.02)] were observed. No differences were found in temperature (p=0.50) and procedure time (p=0.09). When comparing residents' post-training scores with those of experts, no significant differences were found in OSATS (p=0.16), SRS (p=0.11), temperature measurement (p=0.50), or procedure time (p=0.09).

Conclusions: The plaster cast removal simulation model proved to be an effective training tool for residents, enabling them to achieve expert-level competency. Significant improvements were observed in OSATS and SRS scores post-training, highlighting the positive impact of the intervention on this skill.