Introduction The role of gender to achieve competency, if not proficiency, has been a contentious issue in all surgical specialities but more so within orthopaedics which is usually male-dominated. Current literature suggests gender differences in surgical skill acquisition. Such performance metrics can be easily measured in one of the commonest orthopaedic procedures using on a virtual reality (VR) haptics-enabled dynamic hip screw (DHS) fixation simulator.
Methods 26 participants were voluntarily recruited (9 women and 17 men). All participants were asked to perform five attempts and following a one-week washout period they were asked to repeat a further five attempts (total 10 attempts). Participants were assessed by seven real-time objective performance metrics. The mean (with standard deviation) and Mann-Whitney U-test for significance (p < 0.05) were both calculated.
Results There were no significant differences found between both cohorts at baseline with respect to any of the seven objective metrics. On the tenth and final attempt, males performed significantly better than females in time taken by being 35% quicker (p = 0.0025), using less fluoroscopy by 53% (p = 0.0096), reduced TAD by 32% (p = 0.0466) and reduced probability of cut-out and failure rate by 39% (p = 0.0488). There were insignificant differences for number of radiographs, attempts of guide wire insertion and global score.
Conclusions This is the first study to demonstrate a significant difference in clinically relevant objective metrics of completing a DHS fixation between genders. Gender plays a role in the acquisition of technical surgical skills. These results may potentially influence and tailor-make the structure of future orthopaedic training programmes according to gender to improve procedural time, total fluoroscopy time, TAD and probability of cut-out. Although, perhaps with more time and number of attempts at the simulation, a significant difference in number of radiographs take, attempts of guide wire insertion and global score may come to surface.
Bridges M, Diamond DL. The financial impact of teaching surgical residents in the operating room. Am J Surg 1999;177(1):28–32
Chikwe J, de Souza AC, Pepper JR. No time to train the surgeons. BMJ 2004;328(7437):418–9
DoH. Guidance on the implementation of the European Working Time Directive. 2004; (July). Available from: http://www.dohc.ie/issues/european_working_time_directive/
Nasca TJ, Day SH, Amis ES. The new recommendations on duty hours from the ACGME Task Force. N Engl J Med 2010;363(2):e3
Philibert I, Friedmann P, Williams WT. New requirements for resident duty hours. JAMA 2002;288(9):1112–4
- Category: Course or curriculum evaluation/innovation/integration
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.