Training simulation for oral and maxillofacial surgeons based on the techniques of arthroscopy in the temporomandibular joint

Arthroscopy is a diagnostic-therapeutic technique used in the treatment of disorders of the temporomandibular joint (TMJ). The difficulties of arthroscopy lie in the manipulation of the tools, which is why training in the technique of triangulation in artificial models is essential. We developed a training system based on the techniques of arthroscopy in the TMJ, using simulators. The first simulator was a metal box containing three holes for insertion of the instruments, and the second was a human artificial model made of polymers. We found that they facilitated training in the techniques of arthroscopy, which subsequently reduced operating time and led to a better execution of skills in reality.

External validation and evaluation of an intermediate proficiency-based knot-tying and suturing curriculum

PURPOSE

The purpose of this study was to perform external validation, examine educational effectiveness, and confirm construct validity of a previously developed "intermediate-level, proficiency-based knot-tying and suturing curriculum" in preparing residents to achieve proficiency in more advanced open surgical techniques.

METHODS

A total of 47 postgraduate year-1 (PGY-1) surgery residents completed 6 intermediate-level knot-tying and suturing exercises. Baseline trainee performance was compared with intermediate and senior (PGY-3 and PGY-4) residents (n = 12) and expert faculty (n = 4).

RESULTS

PGY-1 overall proficiency increased from 21.1% at baseline to 92.1% during posttest for all 6 exercises combined (p < 0.001). When compared with the PGY-3 and PGY-4 residents, at baseline intermediate and senior residents scored higher on half of the exercises. However, during posttesting PGY-1 residents not only matched, but also surpassed PGY-3 and PGY-4 residents' performance in 3 of 6 exercises. Significant differences on all 6 exercises were also found during pretesting when comparing interns against faculty, demonstrating construct validity. However, upon completion of the curriculum, PGY-1 residents' posttest scores were equivalent, if not significantly better than expert faculty performance.

CONCLUSION

We obtained similar results as those previously reported, showing external validation. Additionally, we demonstrated that first-year surgical residents could achieve performance levels that match or exceed those of senior residents and experienced surgeons on these exercises with 4 weeks of training.