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Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Nov 18, 2025; 16(11): 110251
Published online Nov 18, 2025. doi: 10.5312/wjo.v16.i11.110251
Enhancing orthopaedic competency through simulation: A student-centered approach to bridge educational gaps
Mithun Manohar, Preethi Selvaraj, Pradeep Selvaraj, Naveen Jeyaraman, Sathish Muthu, Madhan Jeyaraman
Mithun Manohar, Department of Orthopaedics, Shri Sathya Sai Medical College and Research Institute, Chengalpattu 603108, Tamil Nadu, India
Preethi Selvaraj, Department of Community Medicine, Faculty of Medicine–Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600095, Tamil Nadu, India
Pradeep Selvaraj, Department of Community Medicine, Chettinad Institute of Medical Sciences, Chennai 603108, Tamil Nadu, India
Naveen Jeyaraman, Sathish Muthu, Madhan Jeyaraman, Department of Orthopaedics, Orthopaedic Research Group, Coimbatore 641045, Tamil Nadu, India
Naveen Jeyaraman, Madhan Jeyaraman, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India
Sathish Muthu, Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram 631552, Tamil Nadu, India
Author contributions: Manohar M, Selvaraj P, Jeyaraman N, and Muthu S contributed to acquiring clinical data and performing the data analysis; Selvaraj P contributed to administration; Selvaraj P and Jeyaraman M contributed to conceptualization; Selvaraj P and Jeyaraman M contributed to manuscript writing; Muthu S and Jeyaraman M contributed to manuscript revision; Jeyaraman M contributed to proofreading; All authors have agreed to the final version to be published and agree to be accountable for all aspects of the work.
Institutional review board statement: The manuscript has been approved by the Institutional Ethics Clearance.
Informed consent statement: All participants provided informed consent.
Conflict-of-interest statement: All authors declare no conflicts of interest in publishing the manuscript.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Madhan Jeyaraman, MD, PhD, Researcher, Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Velappanchavadi, Chennai 600077, Tamil Nadu, India. madhanjeyaraman@gmail.com
Received: June 4, 2025
Revised: June 25, 2025
Accepted: September 19, 2025
Published online: November 18, 2025
Processing time: 165 Days and 0.1 Hours
Abstract
BACKGROUND

Orthopedic training, one of the most useful but under-represented specialties in undergraduate medical curricula, has some difficulties in clinical teaching.

AIM

To determine if simulation-based learning (SBL) was effective in enhancing procedural accuracy, skill confidence, and knowledge recall in final-year medical students.

METHODS

This was a cross-sectional observational study performed in the Department of Orthopaedics in a tertiary care teaching hospital with simulation training facilities. The trial was conducted over 2 months (January 2025-February 2025) and was designed to determine the effect of SBL on procedural skills, knowledge retention, and self-perceived confidence in a group of final-year medical students. The inclusion criterion was undergraduate medical students in their final year who had clinical postings in orthopedics. Convenience sampling was used to recruit 106 students. The sample size was estimated to achieve a post-training 50% improvement ratio in procedural accuracy, a confidence interval of 95%, and an absolute precision of 10%. The simulation sessions included exercises with synthetic bone models, cast equipment, and procedural packs [orthopedic skills: (1) Closed fracture reduction; (2) Application of plaster; and (3) Traction]. Each session consisted of an instructor-led demonstration, practice under supervision, and immediate feedback.

RESULTS

In our study involving 106 final-year medical students, SBL significantly improved procedural accuracy with scores rising from 62.5% to 84.9% (P < 0.001). Knowledge retention also improved markedly with post-test scores increasing from 63.4% to 78.2% (P < 0.001). Self-reported confidence levels showed a substantial gain, increasing from 4.6 to 8.2 on a 10-point scale. Prior simulation exposure and academic performance ≥ 75% were significantly associated with higher post-training accuracy. Gender had no significant influence on outcomes.

CONCLUSION

The current study attested to the value of SBL in the enhancement of procedural skills, knowledge retention, and self-confidence of final-year medical students in orthopedics.

Keywords: Simulation-based learning; Orthopedic education; Medical students; Procedural accuracy; Medical education

Core Tip: Simulation-based learning enhances procedural accuracy, knowledge retention, and self-confidence in final-year medical students training in orthopedics. This study showed significant improvements in accuracy (62.5%-84.9%, P < 0.001) and knowledge recall (63.4%-78.2%, P < 0.001). Students reported higher confidence levels post-training. Prior simulation exposure and strong academic performance were linked to better outcomes. These findings support the integration of simulation-based teaching in undergraduate medical education for improved skill acquisition.