Exploring Trauma Simulation: Insights from the Simulation in Trauma Across Resident Training (START) Study and Trainee Experiences

Introduction and objective Advancements in technology have presented an opportunity to incorporate simulation training into the trauma and orthopedic (T&O) curriculum. This study aimed to assess the perspective of T&O trainees regarding the acceptability and perceived educational impact of simulation training before and after a training day. This includes identifying the resources that trainees are likely to use and find helpful when preparing for a new or unfamiliar procedure, as well as evaluating their opinions on different levels of simulation fidelity. The null hypothesis for this study is that there is no difference in educational value after exposure to various simulation modalities. Methods This was a three-arm crossover cohort observational study involving 18 T&O specialty trainees in their first three years of training who attended a simulation training course, involving four independent stations with simulation tasks of varying fidelities. Pre-course and post-course questionnaires with a 10-point Likert scale to determine if simulation training exposure affected the perception of educational value. Data were treated non-parametrically with median (±median absolute deviation; 95% Bonnett-Price CI). Statistical significance was calculated using the Mann-Whitney U test and set as p<0.05. Results Twelve trainees (67%) had not previously used orthopedic simulators to prepare for unfamiliar operations. Ninety-four percent of trainees thought that simulation training could support safe practice, and all trainees considered simulation to be useful for training. Trainees strongly emphasized the importance of simulation training (pre-course vs. post-course median score: 7 vs. 9, p=0.01), the necessity for it to be readily assessable (9 vs. 10, p=0.061), its role in formal assessment (4 vs. 8, p=0.006), and being able to become a better surgeon from it (7 vs. 8, p=0.078). Conclusions T&O trainees acknowledged the value of simulation training in complementing their operating numbers; however, their access to these resources was limited - a problem well recognized in current literature. The gap in the implementation of simulation training should be addressed for T&O trainees to benefit from these resources fully.