Development And Preliminary Evaluation Of Auricle Reconstruction Simulation Training System Based On Digital Technology

BackgroundAutologous costal cartilage auricle reconstruction is the main treatment modalities for microtia.However,autologous costal cartilage auricle reconstruction is very complicated and requires very high ability of doctors.It takes a long time to train a mature auricle reconstruction doctor.Therefore,the establishment of a systematic simulation training system for autologous costal cartilage auricle reconstruction is of great significance to the training of orthopaedic specialists and the improvement of the interest of postgraduates in orthopaedic surgery.PurposeThe purpose of this project is to design and develop a digital auricle reconstruction simulation training system and evaluate the application effect of the system.Methods1.The auricle reconstruction simulation training system was designed and developed based on 3D reconstruction and 3D printing technology.2.Standard teaching procedures for auricle reconstruction will be developed.3.Thirty-six volunteers without auricle reconstruction（surgical clinical standardization training students）were divided into two groups（experimental and control groups）for clinical teaching experiments,The experimental group used the auricle reconstruction simulation training system for teaching and practice.The control group was taught and practiced with books,PPT,surgical videos and carrots.The teaching effect of the simulation system was preliminary evaluated.Correlation and independent nonparametric tests were used for inter-and intra-group data analysis,and an effective student satisfaction survey was conducted.Results1.The auricle reconstruction simulation training system was constructed based on digital technology.The simulation system included:（1）head,face and neck model with auricular-temporal area emptied;（2）left and right auricular-temporal area cylinder with auricular;（3）left and right auricular-temporal cylinder without auricular;（4）The 6^th,7^th,8^thand 9^thsimulated costal cartilages;（5）Simulated skin of different thickness;（6）Negative pressure and pressure measurement system.2.Standard teaching procedures for auricle reconstruction were developed,including preoperative communication,intraoperative operation and postoperative communication and nursing.3.In the experimental group,the consistency of pre-intervention score（ICC=0.960,P<0.001）and post-intervention score（ICC=0.971,P<0.001）was better.In the control group,the consistency of pre-intervention score（ICC=0.896,P<0.001）and post-intervention score（ICC=0.926,P<0.001）was better.Pre-intervention test scores of theory part[8.00（4.75,11.25）vs 5.50（3.75,12.25）;P=0.668]and design part[2.00（0.00,4.25）vs 1.00（1.00,2.25）;P=0.674]was not statistically significant,indicating comparability.The scores of both groups improved significantly after intervention.The theoretical test scores of before and after intervention was the experimental group score[8.00（4.75,11.25）vs 16.50（13.00,19.25）;P<0.001]and design test scores[2.00（0.00,4.25）vs 7.00（6.00,10.00）;P<0.001].Compared theoretical test scores of pre-intervention and post-intervention of the control group[5.50（3.75,12.25）vs 11.00（9.50,16.25）;P<0.001]and design test scores[1.00（1.00,2.25）vs 5.00（3.75,6.00）;P<0.001],the improvement in the simulator group was more significant,P<0.001.Compared to traditional teaching,the simulation system have better teaching results（P<0.001）,which could enhance volunteers’interest and learning ability（P<0.001）,learn the topic content better（P<0.001）,and increased independent thinking skills（P<0.001）.This system was a more effective method for surgical skills teaching（P<0.001）,and all participants tended to recommend the simulation system to others（P<0.001）.Conclusions1.In this study,a new auricle reconstruction simulation training system was developed based on digital technology,including auricle positioning,auricle photographic film fabrication,intraoperative auricle stent carving,stent placement of the first and second stages of auricle reconstruction,and postoperative morphology and position evaluation and analysis.2.This system can assist teachers in teaching more systematically in auricle reconstruction training with autologous costal cartilage,and improve the teaching effect.