JAAOS - 2026-08-01 - Journal Article
Evaluation of a Novel Educational Three-Dimensionally-Printed, Unstable, Distal Radius Fracture Model for Reduction and Splinting.
Sullivan BT, Miles M, Lee ND, Aziz KT, Raeker-Jordan EA, Yohe G, Shimada K, LaPorte D, Giladi AM, Means KR
Topics
Key Takeaway
PGY-1 residents who received formal teaching with a 3D-printed unstable distal radius fracture model scored significantly better on global rating scale assessment (P<0.05) compared to untrained PGY-1 controls, supporting construct validity of the model.
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Summary
This study evaluated construct validity and educational utility of a novel 3D-printed unstable DRF model by testing 33 residents across all PGY levels from multiple institutions. Fourteen PGY-1 residents were block randomized to model-based teaching versus no exposure before a standardized testing session assessing GRS, OSATS, procedure time, final radiographic sagittal tilt, and written examination. Taught PGY-1 residents outperformed untrained PGY-1s on GRS (P<0.05), PGY-1s without prior exposure had longer procedure times than all senior residents (P<0.05), and PGY level correlated with GRS scores, examination performance, and procedure times (P<0.05), confirming construct validity.
Key Limitation
The primary outcome improvement (GRS) was demonstrated only in PGY-1s with approximately 7 per group, and no objective radiographic or OSATS differences were detected, leaving the clinical magnitude of skill transfer unquantified.
Original Abstract
INTRODUCTION
We conducted an initial orthopaedic resident-based evaluation of a novel three-dimensionally (3D) printed model simulating a displaced, unstable distal radius fracture (DRF). We hypothesized the model would have construct validity, enhance beginner resident performance when used for teaching, and be rated as beneficial.
METHODS
Thirty-three residents across all postgraduate years (PGY) from multiple institutions participated. We gathered baseline clinical DRF experience levels for each through Accreditation Council for Graduate Medical Education case logs. We block randomized 14 PGY-1 residents into two groups: no exposure versus formal teaching with the model before testing. All other residents carried out testing without prior exposure. All PGY residents completed a single model testing session including reduction, splinting, and fluoroscopy, with standardized performance assessments by a board-certified hand surgery fellowship-trained orthopaedic surgeon. Performance metrics for each session included a global rating scale (GRS), an objective structured assessment of technical skills, reduction/splinting time, final radiographic sagittal tilt, and a DRF written examination. We also gathered anonymous feedback on the model.
RESULTS
PGY-1 residents taught with the model scored markedly better per GRS ( P < 0.05). No notable differences were found between the randomized PGY-1 groups for the objective structured assessment of technical skills, procedure times, or examinations ( P > 0.05). PGY-1 residents with no prior exposure had markedly longer group-level procedure times than all other PGY residents with no prior exposure, supporting construct validity for the model ( P < 0.05). Furthermore, PGY level markedly correlated with better GRS and examination scores and procedure times ( P < 0.05). Baseline DRF experience was also markedly associated with better GRS scores ( P < 0.05). Anonymous resident feedback indicated that they would recommend the 3D-printed DRF models to improve education.
DISCUSSION
Our 3D-printed unstable DRF model demonstrated construct validity across multiple domains. PGY-1 residents taught with the model scored better on the GRS, suggesting potential improved skill acquisition and assessment. All PGY residents recommended the models for DRF education.