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Education of parents in Pavlik harness application for developmental dysplasia of the hip using a validated simulated learning module.

Gargan KE, Bradley CS, Maxwell A, Moktar J, Wedge JH, Murnaghan ML, Kelley SP - J Child Orthop (2016)

Bottom Line: Parent scores on the OSATS improved to the level of expert clinicians both immediately post-intervention and at retention testing.The control group did not improve nor were they considered competent.However, the challenges parents face in understanding the more detailed subtleties of medical care suggest that they still require an appropriate level of supervision by clinicians to ensure effective treatment.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.

ABSTRACT

Background: The Pavlik harness is the most common initial treatment for developmental dysplasia of the hip worldwide. During treatment, parents are required to re-apply the harness at home. Teaching parents how to apply the harness is therefore paramount to success. While simulated learning for medical training is commonplace, it has not yet been trialed in teaching parents how to apply a Pavlik harness.

Methods: A group of parents underwent a simulated learning module for Pavlik harness application. Parents were evaluated pre- and post-exposure and at one month after testing. A validated objective structured assessment of technical skill (OSATS) and a global rating scale (GRS) specific to Pavlik harness application were used for evaluation. A control group of parents was also tested at both time points. A clinical expert group was used to determine competency. ANOVA and t tests were used to assess differences between groups and over time.

Results: Parent scores on the OSATS improved to the level of expert clinicians both immediately post-intervention and at retention testing. However, on the GRS, only half were considered competent due to their inability to achieve the required hip positions. The control group did not improve nor were they considered competent.

Conclusions: The use of a simulated learning module improves both the confidence and skill level of parents in the application of the Pavlik harness. However, the challenges parents face in understanding the more detailed subtleties of medical care suggest that they still require an appropriate level of supervision by clinicians to ensure effective treatment.

No MeSH data available.


Related in: MedlinePlus

Global rating scalesFigure reproduced with permission. Promotional and commercial use of the material in print, digital or mobile device format is prohibited without the permission from the publisher Wolters Kluwer Health. Please contact healthpermissions@wolterkluwer.com for further information [16]
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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Fig1: Global rating scalesFigure reproduced with permission. Promotional and commercial use of the material in print, digital or mobile device format is prohibited without the permission from the publisher Wolters Kluwer Health. Please contact healthpermissions@wolterkluwer.com for further information [16]

Mentions: All videos were scored by one content expert (CB) using the validated OSATS specific to Pavlik harness application and a modified global rating scale (GRS) to evaluate both how the skill was performed and the quality of the final product. The OSATS (Electronic Supplementary Material) is a 25-item checklist of skills that was derived from international expert consensus [16]. Items performed correctly are given a score of one for a total possible score of 25. The GRS is scored from very poor (score of 1) to clearly superior (score of 5) (Fig. 1). All three measurements have previously been shown to have excellent reliability and validity [16].Fig. 1


Education of parents in Pavlik harness application for developmental dysplasia of the hip using a validated simulated learning module.

Gargan KE, Bradley CS, Maxwell A, Moktar J, Wedge JH, Murnaghan ML, Kelley SP - J Child Orthop (2016)

Global rating scalesFigure reproduced with permission. Promotional and commercial use of the material in print, digital or mobile device format is prohibited without the permission from the publisher Wolters Kluwer Health. Please contact healthpermissions@wolterkluwer.com for further information [16]
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940246&req=5

Fig1: Global rating scalesFigure reproduced with permission. Promotional and commercial use of the material in print, digital or mobile device format is prohibited without the permission from the publisher Wolters Kluwer Health. Please contact healthpermissions@wolterkluwer.com for further information [16]
Mentions: All videos were scored by one content expert (CB) using the validated OSATS specific to Pavlik harness application and a modified global rating scale (GRS) to evaluate both how the skill was performed and the quality of the final product. The OSATS (Electronic Supplementary Material) is a 25-item checklist of skills that was derived from international expert consensus [16]. Items performed correctly are given a score of one for a total possible score of 25. The GRS is scored from very poor (score of 1) to clearly superior (score of 5) (Fig. 1). All three measurements have previously been shown to have excellent reliability and validity [16].Fig. 1

Bottom Line: Parent scores on the OSATS improved to the level of expert clinicians both immediately post-intervention and at retention testing.The control group did not improve nor were they considered competent.However, the challenges parents face in understanding the more detailed subtleties of medical care suggest that they still require an appropriate level of supervision by clinicians to ensure effective treatment.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.

ABSTRACT

Background: The Pavlik harness is the most common initial treatment for developmental dysplasia of the hip worldwide. During treatment, parents are required to re-apply the harness at home. Teaching parents how to apply the harness is therefore paramount to success. While simulated learning for medical training is commonplace, it has not yet been trialed in teaching parents how to apply a Pavlik harness.

Methods: A group of parents underwent a simulated learning module for Pavlik harness application. Parents were evaluated pre- and post-exposure and at one month after testing. A validated objective structured assessment of technical skill (OSATS) and a global rating scale (GRS) specific to Pavlik harness application were used for evaluation. A control group of parents was also tested at both time points. A clinical expert group was used to determine competency. ANOVA and t tests were used to assess differences between groups and over time.

Results: Parent scores on the OSATS improved to the level of expert clinicians both immediately post-intervention and at retention testing. However, on the GRS, only half were considered competent due to their inability to achieve the required hip positions. The control group did not improve nor were they considered competent.

Conclusions: The use of a simulated learning module improves both the confidence and skill level of parents in the application of the Pavlik harness. However, the challenges parents face in understanding the more detailed subtleties of medical care suggest that they still require an appropriate level of supervision by clinicians to ensure effective treatment.

No MeSH data available.


Related in: MedlinePlus