A mixed methods systematic review : does computer-based simulation (CBS) in fracture surgery leads to better knowledge, skills and competencies than traditional preparation?

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Abstract

Objectives
To identify original research studies comparing CBS to traditional surgical preparation for fracture surgery and to analyse and synthesise the results to support the hypothesis that CBS is better than traditional methods in preparation for fracture surgery.

Methods
Four databases ‘Web of Science', ‘Embase', ‘Medline' and ‘OrthoSearch' were searched using the terms ‘orthopaedic', ‘fracture', ‘simulation' and ‘education'. Two relevant journals, two conferences and two registries were hand searched. All searches were between Jan 2010 and April 2022. Selected articles underwent a backwards and forwards citation search. 1,285 articles were identified and screened for selection. Two reviewers independently extracted outcome data and completed a risk of bias analysis. Selected studies were included in a direction of effect synthesis and appropriate studies were included in a meta-analysis.

Results
15 studies totalling 350 participants, measuring the development of participants’ knowledge, skills, and competencies, were included for direction of effect analysis. 86% (13/15) favoured CBS over traditional preparation. A meta-analysis of 4 studies, totalling 62 participants, measuring OSATS score favoured CBS, Standard Mean Difference = 1.06 (95% CI; -0.34, 2.45) (Z = 1.48)(P = 0.14).

Conclusion
Participants in this systematic review range from medical students to fellows; outcomes measure knowledge, skills and competencies and the control groups varied. Despite this heterogenicity CBS is favoured consistently, and the heterogenicity of these results means this evidence is generalisable to a wide educational context within orthopaedic fracture surgery.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Surgery in Practice and Science
Publisher: Elsevier
ISSN: 2666-2620
Official Date: June 2023
Dates:
Date
Event
June 2023
Published
18 May 2023
Available
16 May 2023
Accepted
Volume: 13
Page Range: p. 100181
DOI: 10.1016/j.sipas.2023.100181
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons open licence)
URI: https://wrap.warwick.ac.uk/184979/

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