Abstract:

Objective

To evaluate the application and effectiveness of a combined hierarchical teaching and virtual simulation teaching （HT-ST） method in the standardized training of orthopedic residents.

Methods

Forty orthopedic residents who received specialized training from September 2021 to September 2022 were selected as the experimental group， and applied a combined hierarchical and virtual simulation teaching approach. Eligible students were stratified based on elements such as years of study and academic performance， and teaching content was restructured according to the stratification of students. Orthopedic theory and clinical skills were implemented through stratified teaching， combined with virtual arthroscope and virtual operating room. The control group consisted of 41 residents trained from September 2020 to September 2021，who received hierarchical teaching only. Both groups were assessed on professional knowledge， clinical thinking ability， clinical work capability， and clinical skill proficiency， and all participants completed a satisfaction survey. T test was used for the measurement data， and Mann-Whitney U test was used for the counting data.

Results

The experimental group demonstrated significantly better performance in professional knowledge acquisition （t=5.851， P＜0.001） and clinical thinking （t=7.942， P＜0.001）. The work capability including disease inquiry and physical examination （t=5.369）， disease diagnosis （t=6.178）， disease treatment （t=6.197），communication with patients （t=6.597）， and case writing （t=6.955） were all better in the experimental group than the control group （all P＜0.001）. The clinical skills including basic first aid skills （t=6.553），physical examination （t=7.176）， orthopedic basic skills （t=7.321） 3， imaging judgment （t=7.387）， operation disinfection and draping （t=8.744） were also better in the experimental group than the control group （all P＜0.001）. The members in the experimental group showed a higher level of satisfaction with the HT-ST method.

Conclusion

The integration of hierarchical teaching with virtual simulation teaching significantly enhanced the training outcomes for orthopedic residents and is considered an effective instructional method. However， the results require further validation with a broader sample.

Key words: Education，medical, Internship and residency, Simulation training