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      Sawbones laboratory in orthopedic surgical training

      review-article
      , MBBS, FRCS(C)
      Saudi Medical Journal
      Saudi Medical Journal

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          Abstract

          Sawbones are artificial bones designed to simulate the bone architecture, as well as the bone’s physical properties. The incorporation of sawbones simulation laboratories in many orthopedic training programs has provided the residents with flexibility in learning and scheduling that align with their working hour limitations. This review paper deliberates the organization of sawbones simulation in orthopedic surgical training to enhance trainee’s future learning. In addition, it explores the implications of sawbones simulation in orthopedic surgical teaching and evaluation. It scrutinizes the suitability of practicing on sawbones at the simulation laboratory to improve orthopedic trainee’s learning. This will be followed with recommendations for future enhancement of sawbones simulation-based learning in orthopedic surgical training.

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          Most cited references28

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          Debriefing with good judgment: combining rigorous feedback with genuine inquiry.

          Drawing on theory and empirical findings from a 35-year research program in the behavioral sciences on how to improve professional effectiveness through reflective practice, we develop a model of "debriefing with good judgment." The model specifies a rigorous reflection process that helps trainees surface and resolve pressing clinical and behavioral dilemmas raised by the simulation. Based on the authors' own experience using this approach in approximately 2000 debriefings, it was found that the "debriefing with good judgment" approach often sparks self-reflection and behavior change in trainees.
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            Learning-performance distinction and memory processes for motor skills: a focused review and perspective.

            Behavioral research in cognitive psychology provides evidence for an important distinction between immediate performance that accompanies practice and long-term performance that reflects the relative permanence in the capability for the practiced skill (i.e. learning). This learning-performance distinction is strikingly evident when challenging practice conditions may impair practice performance, but enhance long-term retention of motor skills. A review of motor learning studies with a specific focus on comparing differences in performance between that at the end of practice and at delayed retention suggests that the delayed retention or transfer performance is a better indicator of motor learning than the performance at (or end of) practice. This provides objective evidence for the learning-performance distinction. This behavioral evidence coupled with an understanding of the motor memory processes of encoding, consolidation and retrieval may provide insight into the putative mechanism that implements the learning-performance distinction. Here, we propose a simplistic empirically-based framework--motor behavior-memory framework--that integrates the temporal evolution of motor memory processes with the time course of practice and delayed retention frequently used in behavioral motor learning paradigms. In the context of the proposed framework, recent research has used noninvasive brain stimulation to decipher the role of each motor memory process, and specific cortical brain regions engaged in motor performance and learning. Such findings provide beginning insights into the relationship between the time course of practice-induced performance changes and motor memory processes. This in turn has promising implications for future research and practical applications. Copyright © 2011 Elsevier B.V. All rights reserved.
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              A review of the validity and accuracy of self-assessments in health professions training.

              Valid self-assessment is fundamental to continuing professional competence but is seldom explicitly taught in health professions training. This review analyzed 18 scholarly articles published between January 1970 and February 1990 (14 articles regarding health professions trainees, and four concerning college students or graduate trainees) in which it was possible to compare performance as self-assessed by trainees with performance as assessed by experts or objective tests. The validity of self-assessed performance was found to be low to moderate and did not improve with time in conventional health professions training programs. Self-assessed performance seemed closely related to generalized self-attributions and was minimally influenced by external feedback in the form of test scores, grades, or faculty assessments. In five programs emphasizing explicit self-assessment goals and training strategies, moderate-to-high validity outcomes or improvements over time were demonstrated. Much of what passes for self-assessment in training seems the exercise of an underdeveloped skill, but effective training to improve validity and accuracy is available and feasible.
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                Author and article information

                Journal
                Saudi Med J
                Saudi Med J
                Saudi Medical Journal
                Saudi Medical Journal (Saudi Arabia )
                0379-5284
                April 2016
                : 37
                : 4
                : 348-353
                Affiliations
                [1] From the Department of Orthopedics Surgery, Medical College, Taibah University, Al Madinah Al Munawarah, and Jeddah University, Jeddah, Kingdom of Saudi Arabia
                Author notes
                Address correspondence and reprint request to: Dr. Bandar M. Hetaimish, Department of Orthopedics Surgery, Medical College, Taibah University, Al Madinah Al Munawarah, Kingdom of Saudi Arabia. E-mail: dr_hetaimish@ 123456hotmail.com
                Article
                SaudiMedJ-37-348
                10.15537/smj.2016.4.13575
                4852011
                27052276
                e89e3b5e-0022-4e2b-8877-ac8958e4de51
                Copyright: © Saudi Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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