Can we make arthritis surgery better and safer for patients by training surgeons using donated human bodies?

Disease - Osteoarthritis, traumatic fracture, joint replacement

Lead applicant - Mrs Hannah James

Organisation - University of Warwick

Type of grant - Educational Research Fellowship

Status of grant - Active

Amount of the original award - £149,998

Start date - 1 October 2013

Reference - 20485

Public Summary

What are the aims of this research?

  1. To map the learning curve of trainee orthopaedic (bone and joint) surgeons as they perform their first few operations
  2. To investigate whether provision of an intensive training course using donated deceased human bodies (cadavers) enhances this learning curve
  3. To understand the attitudes of trainees and trainers (senior surgeons) to this type of training
  4. To explore the feasibility of introducing this type of training into the formal curriculum for Trauma Orthopaedic Surgery.

Why is this research important?

Due to changes in working regulations, today's trainee surgeons will have fewer hours of experience in the operating theatre by the time they become consultants than in the past. The government has emphasised the need to explore additional ways of training surgeons that provide realistic yet safe training.

In the modern NHS it is rightly considered unacceptable to allow trainee surgeons to practise operations on living patients. One way of overcoming this problem is by using simulated surgery. Much in the same way as pilots learn to fly aeroplanes using a flight simulator before doing it for real, surgeons can first learn to do operations using simulation. A recent change in the law has allowed cadavers to be used in the training of surgeons. As cadavers have the same anatomy as a living patient the experience of surgery can therefore be replicated in an accurate and sophisticated way.

However, we don't yet know whether this type of training will help trainee surgeons to learn operations more quickly and to a higher standard. This needs to be proved in order for the NHS and medical schools to invest public money in providing the necessary facilities across the UK.

How will the findings benefit patients?

This research project offers three major potential benefits for patients:

  1. Trainee surgeons could achieve a high level of skill before operating on living patients.
  2. Surgeons can learn to perform increasingly complex arthritis surgery such as joint replacements. Research has shown that factors such as placement of the skin incision and precise sizing and fitting of the implants can affect the outcomes of surgery. If these skills can be learnt using cadaveric simulation it could help to ensure the best possible outcomes for patients.
  3. This research will also help develop measures for assessing surgeons' technical skill, which could potentially be used to assess whether surgeons are ready to proceed to the next stage of their training.