Via Research Recognition Day 2024 VCOM-Carolinas

Educational Reports

COST-EFFECTIVE MODEL OF A COLLES FRACTURE TO IMPROVE CONFIDENCE AND PROFICIENCY IN CLOSED FRACTURE REDUCTION Erik Benson, OMS-II, Anthony Chaknis, OMS-II, Morgan Minner, OMS-II, Madison Sacks, OMS-II, Dr. Tom Lindsey, DO, Michael Parks, MPA, NREMT

Edward Via College of Osteopathic Medicine - Carolinas, Simulation Center, Spartanburg, SC. Co-authorship should be given to collaborators such as a Statistician, who have made intellectual contribution in terms of writing, research design, study implementation, and data analysis and interpretation.

Introduction

Results

Results cont.

Methods ● Colles fractures are a common orthopedic injury seen when falling on an outstretched hand, and pose significant neurovascular complications if not reduced effectively. 4 ● The dorsal displacement of the distal radius occurring in this injury may compromise the radial artery, restricting perfusion to the hand. 4 ● There are no commercially available Colles Fracture Reduction models that simulate recovery of blood flow and subsequent pulse upon proper reduction. ● Fracture Reduction Models have been studied extensively among residents and prove to be beneficial 3 , yet studies have not been performed extensively involving medical students. ● The knowledge and proper demonstration of fracture reduction with pulse recovery will enhance the quality of medical education, ultimately contributing to improved patient outcomes and reduced long-term complications associated with Colles fractures. ● This project was established to develop a cost-effective model designed to enhance medical students’ proficiency and confidence of performing a closed reduction of a Colles fracture. ● The model had silicone rubber flesh and skin as well as dense plastic bones. Embedded into the model were electronics to detect the displacement of the bones and a motor to simulate a palpable pulse. ● 37 Participants: 18 in Experiment(A) & 19 in Control(B) ● Presentation on the identification, classification and management of Colles Fractures ● Control received just presentation and Experiment received presentation and hands-on training

After attending the presentation, 71% more students could correctly identify steps of Colles Fracture Reduction.

Figure 5. Clinical Application of Fracture Model

Discussion

● The study aimed to enhance medical students’ proficiency in orthopedic trauma, focusing on fracture reduction skills. ● While previous research primarily focused on residents, our study targeted medical students. 1 ● Our model uniquely simulates the ragaining of pulse post-reduction, setting it apart from existing Colles’ fracture models ● By conducting a presentation on Colles fracture, we observed that theoretical knowledge alone did not instill confidence in students’ ability to perform real-life fracture reductions. ● However, hands-on training with our fracture reduction model significantly boosted students’ confidence, as indicated in Figure 4. ● All students acknowledged the model’s effectiveness in improving their confidence for real-world fracture reduction scenarios. ● Future studies will incorporate this model during VCOM Trauma Day to further enhance medical student proficiency in emergent fracture reduction. ● Our cost-effective model can be a precedent for medical students to acquire essential skills before residency training. ● With additional refinement, we aim to enhance the model’s functionality, including the ability to simulate specific fracture positions and placement in finger traps.

Figure 3. Comparing answer choices of steps in reducing a Colles Fracture of both Control and Experiment

Do you feel confident in your ability to perform a Colles Fracture reduction on a real patient? After the presentation in the control group, there was a 16% increase in students’ confidence of performing a fracture reduction. After the presentation and practice with the forearm model, there was a 78% increase in students’ confidence of performing a fracture reduction.

● Surveys were administered both prior to and following the training sessions for each group ● The hands-on training consisted of a brief explanation of model’s capability to replicate a displaced Colles Fracture with a demonstration of the proper exaggeration, traction, and flexion to reduce a Colles Fracture ● Following the demonstration participants performed the reduction with guidance and feedback from an instructor. ● Collected Data was divided by session timing

Conclusion

After the presentation and forearm model practice, 84% of students felt moderately confident in performing a fracture reduction on a real patient.

Experimental Group Survey Question

● Existing literature covers various fracture model studies, with limited focus on medical students or simulating pulse-recovery following successful reduction. ● Beyond conceptual understanding gained through presentations, our model enhances practical confidence and preparedness, providing a valuable bridge to real-life scenarios.

References

1. Olson, N., Griggs, J., Balhara, K. S., Kann, K., April, M. D., & Olson, A. S. (2022). Evaluation of a Hands-On Wrist Fracture Simulator for Fracture Management Training in Emergency Medicine Residents. Cureus , 14 (7), e27030. https://doi.org/10.7759/cureus.27030 2. Karam, M. D., Kho, J. Y., Yehyawi, T. M., Ohrt, G. T., Thomas, G. W., Jonard, B., Anderson, D. D., & Marsh, J. L. (2012). Application of surgical skill simulation training and assessment in orthopaedic trauma. The Iowa orthopaedic journal , 32 , 76–82. 3. Dixon, W., Miller, N., Toal, G. G., Sebok-Syer, S. S., & Gisondi, M. A. (2021). Development of a 3D printed simulator for closed reduction of distal radius fractures. Perspectives on medical education , 10 (3), 192–195. https://doi.org/10.1007/s40037-020-00609-wDixon, W., Miller, N., Toal, G. G., Sebok-Syer, S. S., & Gisondi, M. A. (2021, June). Development of a 3D printed simulator for closed reduction of distal radius fractures . Perspectives on medical education. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8187689/ 4. Hansen, J. T., Netter, F. H., Machado, C. A. G., Craig, J. A., Perkins, J. A., Marzejon, K. W., & DaVanzo, T. S. (2022). Netter's clinical anatomy (Fifth, Ser. [netter basic science]). Elsevier.

Figure 2. Fracture Model Display

Figure 1. Fracture Model Internal Structure

Figure 4. Evaluating students’ confidence levels in reducing Colles Fracture

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2024 Research Recognition Day