[Artículo traducido] Modelo de simulación de retirada de yesos para el entrenamiento de residentes

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 < .05.

Results

Significant improvements in OSATS [(pre 22 points (range: 20-24); posttraining 25 (range: 25-28) (P = .03)] and SRS [pre 8.5 points (range: 7-9); post 10 points (range: 8-10) (P = .02)] were observed. No differences were found in temperature (P = .50) and procedure time (P = .09). When comparing residents’ post-training scores with those of experts, no significant differences were found in OSATS (P = .16), SRS (P = .11), temperature measurement (P = .50), or procedure time (P = .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.