# Evaluation of Experience, Training, and Hand Dominance on Drilling Accuracy in Orthopedic Surgeons—A Preliminary Study

## TL;DR

This study explores how experience, training, and hand dominance affect drilling accuracy in orthopedic surgeons using a synthetic bone model.

## Contribution

The study introduces a novel evaluation of how left-handedness and simulation-based training influence drilling accuracy in orthopedic surgeons.

## Key findings

- Experts showed superior baseline accuracy, especially with their non-dominant hand.
- Senior residents showed trends toward improvement in right-hand accuracy after training.
- Left-handed participants outperformed right-handed peers with their non-dominant hands.

## Abstract

Background and Objectives: To evaluate the association of surgeon experience, simulation-based training, and hand dominance on drilling accuracy using a synthetic bone model, with the hypothesis that training improves resident performance and left-handed individuals show superior bilateral accuracy. Materials and Methods: A prospective observational study was conducted in the Orthopedic Surgery Division of a tertiary academic center. Drilling accuracy was assessed before and after a standardized simulation-based training program. Twenty-five orthopedic surgeons participated: 9 junior residents (≤3 years of training), 8 senior residents (>3 years), and 8 board-certified experts. All participants completed baseline assessments; only residents were evaluated immediately after training and at a 2-week follow-up. Results: Experts showed superior baseline accuracy, particularly with the non-dominant hand. Senior residents showed a significant overall effect of time on right-hand accuracy (F(2,14) = 5.85, p = 0.014); post hoc pairwise comparisons showed trends toward improvement from baseline to post-training (p = 0.06) and from post-training to 2-week follow-up (p = 0.105); Junior residents showed no significant changes. Left-handed participants consistently outperformed right-handed peers with their non-dominant hands (p = 0.034). Among residents, this pattern persisted across all sessions. At baseline, senior residents and experts had similar right-hand accuracy (p = 0.59), but senior residents performed worse with the left hand (p = 0.038). No significant differences were found between junior and senior residents in either hand across all time points, indicating that residency duration alone does not improve performance without targeted training. Conclusions: Drilling accuracy in orthopedic surgery is influenced by experience level, targeted training, and hand dominance. Experts show greater precision, and senior residents showed a significant overall effect of time on right-hand accuracy, with trends toward improvement following training, while junior residents may need different training strategies. Tailored educational interventions are needed to improve accuracy and ambidexterity across all training stages. Level of evidence: II.