Use this URL to cite or link to this record in EThOS:
Title: The impact of cognitive task analysis in orthopaedic trauma and knee surgery simulation training
Author: Bhattacharyya, Rahul
ISNI:       0000 0004 7659 0721
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2019
Availability of Full Text:
Access from EThOS:
Access from Institution:
Background: Virtual reality and cadaveric simulation are expensive and not readily accessible. Innovative and accessible training adjuncts are required to help meet training needs. Cognitive Task Analysis (CTA) has been used extensively to train pilots and in other surgical specialties. However, the use of CTA's within orthopaedics is in its infancy. Aim: The aim of this thesis was to evaluate the effectiveness of CTA to train novices in femoral intramedullary nailing and diagnostic knee arthroscopy. Methods: Design - A modified Delphi technique was used from three expert orthopaedic surgeons to design a Generic Cognitive Task Analysis (GCTA) Wizard tool. This tool was used to generate a femoral intramedullary nailing CTA tool. A similar technique was employed to design a CTA tool on diagnostic knee arthroscopy. The format of these CTA tools allowed the use of written and audio-visual modalities simultaneously to learn each phase of the surgical procedure. Validation - A Randomized Controlled Trial (RCT) was undertaken with novice undergraduate medical students. They were randomized into two equal groups using either the CTA learning tool or a standard operative technique manual. Assessment was undertaken using the validated Touch Surgery TM assessment tool on femoral intramedullary nailing. A separate RCT was undertaken with junior orthopaedic trainees who were novices in diagnostic knee arthroscopy. They were assessed on a high fidelity phantom limb simulator using the validated ASSET global rating scale. Results: The post test results analysis showed that the intervention group using the femoral nailing CTA tool significantly outperformed the control group. Similarly, the group using the knee arthroscopy CTA tool had significantly higher ASSET scores compared to the control group. Conclusions: This research designed the first CTA learning tools in orthopaedic training. They demonstrated significant objective benefits to train novices in femoral intramedullary nailing and diagnostic knee arthroscopy.
Supervisor: Gupte, Chinmay M. ; Bhattacharya, Rajarshi Sponsor: AO Foundation
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral