Grants We Funded

Abstract
Simulation has proven a useful tool both for teaching junior surgeons and for assessing technical competence. It is used for these purposes in many disciplines, including general surgery, minimally invasive surgery, urology, and more. The abstract nature of many plastic surgery procedures makes developing and validating simulators more challenging than for other specialties. This study fills that void by rigorously evaluating the content and construct validity of a recently developed high-fidelity unilateral cleft lip surgical simulator. This prospective cohort study will evaluate technical performance and perceived comfort level of trainees of varying levels before and after three attempts at operating on the unilateral cleft lip simulator (initial uncoached attempt, after debriefing, and three months later). Subjects' confidence performing cleft lip repair will be assessed before and after the intervention. Each attempt at the operation will be formally evaluated using the validated “Global Rating Scale of Operative Performance,” a novel composite cleft lip repair score, and direct anthropometry. To assess content validity and knowledge retention (ie. value as a teaching tool) scores from attempts 1 (before debrief), 2 (after debrief), and 3 (3 months later) will be compared within individuals. To assess construct validity, scores across participant levels will be compared to determine the degree to which the simulator can discriminate between learner levels. Demonstrating content and construct validity are essential before any simulator is integrated into formal surgical education and before it can be utilized as an instrument to evaluate competency. The specific aim of this research study is to determine if a high fidelity cleft lip simulator possesses these qualities with the longer-term goal of integrating this and other high fidelity simulators into plastic surgery and training credentialing and thus improving patient care.

Biography
Dr. Rogers-Vizena is a plastic surgeon at Boston Children’s Hospital (BCH). She completed a plastic surgery residency at the University of Wisconsin followed by a craniofacial fellowship at BCH. Her current clinical activities include a growing cleft practice with academic pursuits paralleling her clinical interests. She serves as BCH’s clinical lead for implementing the International Consortium for Health Outcomes Measurement (ICHOM) Cleft Lip and Palate Standard Set and serves as scientific co-chair for benchmarking at ICHOM. In addition, she holds two Associate Clinical Directorships within the BCH Simulator program, Director for Plastic and Oral Surgery Services and Special Effects and Materials Science. These positions lead to the development of the high fidelity cleft lip simulator discussed in this proposal as well as other efforts in simulation and 3D printing-based teaching, team training, and patient-specific surgical planning. Fostering the next generation of surgeons is Dr. Rogers-Vizena’s major non-clinical focus. She is engaged in teaching on topics related to cleft lip and palate and craniofacial anomalies for local students, residents, and fellows. She has also fulfilled this goal though the American Society of Maxillofacial Surgeons, where she previously served as resident/fellow representative to the Board of Trustees and recently concluded three years as co-chair of the ad hoc Young Maxillofacial Surgeons Committee.