Paper #I-6

ARE AUDITORY CUES USED TO CONTROL HAND MOTION AND FORCE APPLICATION DURING BONE DRILLING

Christian Veillette, MD

Toronto, ON

Co-Authors

M. Praamsma

D. Backstein

H. Carnahan

D. Gonzalez

A. Dubrowski

Introduction

Our previous research suggests that experts use advanced sensory information to predict the behavior of bone while drilling. We tested the hypothesis that auditory cues are used by experts to control hand motion and force application during bone drilling.

Method

Nineteen participants were divided into two groups based on level of expertise - novice (first year medical students, n=11) and experts (orthopaedic surgeons, n=8). Each participant performed 20 bone drills on a lamb femur bone in the presence (n=10) and absence (n=10) of headphones playing white noise to mask drilling sounds. Primary outcome measures were the amount of plunging of the drill through the bone, and the peak exit velocity of the drill.

Results

Novices plunged more, with higher exit peak velocity than the experts. The experts increased plunging, and exit peak velocity when drilling sounds were masked, while the novices maintained the same amount of plunging and exit peak velocity.

Conclusions

Experts showed a decrease in performance when auditory cues were masked. This suggests that experts use advanced auditory information from the drill (such as pitch) to describe the density of the bone, estimate the depth of bone penetration, and apply accurate force. The results of this study can be applied to enhance teaching of orthopaedic bone drilling skills.