Osteotomy of Three-Dimensional-Printed Distal Radius Malunions: A Performance Comparison of Naïve and Deliberate Practice Training

Surgical education has traditionally relied on apprenticeship, which is limited by the availability of operations and case variability. Deliberate practice (DP) is a structured, goal-directed training method that emphasizes targeted objectives and individualized feedback. This study compared trainee performance in distal radius malunion osteotomy on three-dimensional-printed bone models using naïve practice (NP) versus video-assisted DP. Twelve participants were stratified by expertise level (levels 1 and 2), assigned to either the NP or DP group, and tasked to complete five consecutive trials (E1–E5). Performance was assessed using the Objective Structured Assessment of Technical Skill (score range: 15–75) and analyzed with appropriate statistical methods. Baseline scores (E1) were similar between NP (57.7 ± 7.4) and DP (60.2 ± 9.1; p = 0.87). By E5, DP participants achieved higher scores (72.0 ± 2.8) than NP (67.0 ± 4.5; p = 0.038). Improvement was greatest in level 1 trainees, who demonstrated larger relative gains, despite lower absolute scores compared with level 2 participants These results are consistent with the literature demonstrating the effectiveness of DP in orthopaedics and highlight the complementarity between DP and mental practice. The systematic integration of active, feedback-guided methods—such as video-assisted DP—may shorten the learning curve and raise the performance level of surgical trainees.