Beyond Textbooks: Interactive Learning of Biomechanical Principles of Osteosynthesis with an Online Tool for Orthopaedic Residents

Objectives: This study aimed at evaluating the effectiveness of an online interactive biomechanical teaching tool called OSapp. Our main hypothesis was that through the presentation of appropriate science-based content in an interactive, self-directed learning environment familiar to residents the OSapp could significantly improve the knowledge, comprehension, and retention of clinically relevant biomechanical principles of osteosynthesis.

Design: Thirty-one orthopaedic residents from the same institution were enrolled. Their knowledge of basic biomechanical principles of osteosynthesis was assessed using 24 multiple-choice questions, in 3 assessment rounds: at baseline; directly after a 1-week self-directed OSapp-based learning period; and 2 months later to measure retention. Results of the junior (1-3 years) and senior (4-5 years) resident groups were compared.

Setting: Orthopaedics and Traumatology Department, Italian Hospital of Buenos Aires, Argentina.

Participants: Orthopaedic residents of the same Department at the time of investigation, including residency years 1 to 5.

Results: Twenty-eight participants completed all 3 assessment rounds. Assessment scores significantly improved after the intervention compared to baseline (p < 0.05) and did not decline after 2 months (p > 0.99). Both juniors and seniors showed significant knowledge gain (p < 0.05) that was retained (p > 0.99). Although seniors were better than juniors at baseline (p ≤ 0.01) and postintervention (p < 0.05), after the intervention, juniors reached the level of baseline seniors (p > 0.21). No difference was observed between the 2 groups after 2 months (p > 0.21).

Conclusions: Self-directed learning with the interactive 3D models available in the freely available online tool OSapp led to a significant and sustained improvement of residents' knowledge and understanding of the biomechanical principles of osteosynthesis. Utilizing OSapp in surgical education could help to improve the efficiency and effectiveness of training and may thus lead to decreased fracture treatment complications including failure of osteosyntheses.