The University of Iowa Hospitals and Clinics building is seen from the west on Wednesday, Nov. 8, 2017. A $1.3 million grant now helps UI practicum students to provide counseling services in rural areas across Iowa for the next four years. (Joseph Cress/The Daily Iowan)

University of Iowa researchers develop simulator to ease orthopedic training

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UI researchers develop a new simulator that will give resident surgeons a platform to practice their skills before entering the operating room

By Aadit Tambe

aadit-tambe@uiowa.edu

With researchers developing a new orthopedic simulator, training surgical residents in bone surgery may now be easier and give trainees the advantage of learning from mistakes.

Don Anderson, a University of Iowa professor of orthopedics and rehabilitation and a biomedical engineer, worked with Geb Thomas, a professor of mechanical engineering, and research assistants to create an orthopedic simulator.

“The surgeon has to combine the [many] views and figure how to move their hand. An expert does [this] almost without thinking,” Thomas said. “But for a new person, it takes a little while to figure out.”

The simulator will ease training for residents. It uses wire navigation to repair fractures, Anderson said. There are many places in orthopedics in which the technique of wire navigation is used.

“We also call this a radiation-free fluoroscopy simulator,” Thomas said.

Fluoroscopy is going to be used to teach navigating the wire, Anderson said.

“Wire navigation [would] require radiation, so if you want to practice, you needed to wear lead aprons that protect you from the radiation,” he said. “So this is a way to learn how to do it without actually getting radiation.”

Before the simulator, residents had to be trained in the operating room directly. They did not have a fluoroscopy machine, and if they wanted access to one, they had to borrow it from the operating room if it was not being used.

Residents had to practice in the operating room, under the supervision of a senior doctor, Anderson said.

“It was a very awkward and expensive process without [the simulator],” he said. “So now we can use the [simulator] anywhere — in the skills lab or even on someone’s desk, because it can be plugged into the wall.”

People have used virtual reality as a substitute to train doctors, he said. However, it is very expensive.

“We believe holding a drill and drilling into objects is different from using something that looks like a drill,” Anderson said.

Creation of the simulator started in 2010.

“This model is a result of several iterations, but it’s patented and is the first of its kind,” Thomas said.

As of now, the simulator is being taken to different showings across the country.

“The University of Iowa has six residents per year. That’s not enough to write a journal paper on,” Anderson said. “That’s where it is important to go out on the road.”

The American Board of Orthopedic Surgery and the Orthopedic Trauma Association have supported the simulator.

“Last year, we went [to the American Board of Orthopedic Surgery] to show the simulator and expose some of their faculty to it,” Thomas said. “This year, we are going back and integrating it into one of their training programs.”

The orthopedic simulator would help residents get their first errors out of the way and make them more confident in performing surgery, research assistant Steven Long said in an email to *The Daily Iowan*.

“I think this type of work is so crucial, because it gives orthopedic surgeons a safe place to make mistakes and learn from them without having consequences for patients,” he said. “Anytime you try something out for the very first time, you are bound to either make a mistake, take longer, or not perform up to your full potential.”

Anderson and Thomas hope that the simulator would fundamentally change the training process of residents.

“We [hope to] see this integrated more into how residents perform in the operating room,” Anderson said. “It will be an active part of their training. It will play a role in training them [better] and see their performance transferred to the operation room.”

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