Impact on Confidence, Competence, and Skill Acquisition on Simulation-based Orthopedic Training for Medical Students

Abstract

Introduction: Traditional orthopedic education has relied heavily on didactic instruction and clinical observation. This study evaluates the impact of simulation-based learning (SBL) on both self-reported confidence and objectively assessed technical competence among undergraduate medical students. Materials and Methods: A cross-sectional study was conducted among 106 final-year medical students who completed orthopedic clinical postings. Participants underwent seven simulation exercises, including fracture fixation using synthetic bone models, joint reduction techniques, and arthroscopic navigation. Self-confidence and satisfaction were measured using the validated Student Satisfaction and Self-Confidence in Learning Scale. Objective skill acquisition was assessed using a faculty-rated checklist modeled on the Objective Structured Assessment of Technical Skills. Results: Post-training, the proportion of students reporting high confidence increased from 17% to 56.6% (P < 0.001). Objective skill scores also improved significantly, with a mean increase from 62.4 ± 8.1 to 78.9 ± 6.7 (P < 0.001). Prior simulation exposure and baseline confidence were independent predictors of post-training confidence. Gender did not significantly influence outcomes. High inter-rater reliability (κ = 0.84) supported the consistency of faculty assessments. Conclusion: Simulation-based orthopedic training significantly enhances both perceived confidence and objectively measured competence in undergraduate medical students. The use of validated assessment tools strengthens the reliability of these findings. Early and repeated integration of structured simulation modules into the undergraduate curriculum is recommended to foster clinical readiness and procedural proficiency.