Photo Credit: naumoid

The following is a summary of “Simulation-based training improves developmental hip dysplasia examination and diagnosis skills on newborns,” published in the January 2025 issue of Pediatrics by Gupta et al.

Developmental hip dysplasia (DDH) diagnosis relies on precise examination maneuvers, yet these techniques often translate poorly to video and written curricula, creating challenges in training orthopedic, family medicine, and pediatric residents. This study evaluates the effectiveness of the MiHip simulation-based training program in improving residents’ knowledge, confidence, and clinical diagnostic skills in DDH assessment.

A non-randomized, stepped-wedge study was conducted with 54 pediatric (n=39) and family medicine (n=15) residents during their 2-4 week newborn rotations. The MiHip program involved hands-on training sessions facilitated by a pediatric orthopedic surgeon. Pre- and post-training, residents completed a 10-item knowledge quiz and self-assessed their confidence in DDH examination. Diagnostic skills were evaluated by comparing residents’ and attendings’ hip exam findings across 1,063 newborns. To further validate diagnostic accuracy, chart reviews of 21 newborns who underwent hip ultrasounds compared residents’ and practicing physicians’ diagnoses with ultrasound-confirmed findings.

Post-training, residents demonstrated significant improvements in knowledge, confidence, and diagnostic accuracy (P<0.001). In the clinical setting, confidence and diagnostic sensitivity increased for residents with prior simulation experience (Δ = .29) and those without (Δ = .18). Residents’ diagnoses achieved higher agreement with hip ultrasound findings (88.9%) compared to practicing primary care physicians (25.0%, P = 0.003, φ = .63).

The MiHip simulation-based training effectively enhanced resident knowledge, confidence, and DDH diagnostic skills, resulting in improved clinical performance. The hands-on nature of the program bridged the gap between theoretical learning and practical application, equipping trainees with superior diagnostic capabilities. Future research should explore the broader clinical impact, including potential reductions in orthopedic referral rates and earlier detection of DDH.

Source: sciencedirect.com/science/article/abs/pii/S1876285925000075