Canine Pelvic Limb Model is Valid for Teaching Veterinary Students to Assess Cranial Cruciate Ligament Stability

Abstract

Cranial cruciate ligament (CCL) rupture is the most common canine orthopedic condition and can be diagnosed by eliciting a cranial drawer sign upon examination. However, teaching students to identify this finding is dependent upon caseload and can cause discomfort to a patient. Simulation offers a benign, perpetually available method of teaching students to evaluate stifle stability. This study sought to create and validate a canine stifle model using a validation framework consisting of content evidence and evidence of a relationship with other variables (level of training). The stifle model used a skeleton of anatomically accurate, articulated bones with foam representing soft tissues and silicone skin. A mechanism adjusted cranial drawer from present to absent. Veterinarians ( N  = 22) evaluated the model's features, providing content evidence. Veterinarians, along with 56 veterinary students, palpated two models: one with a stable CCL and one with a ruptured CCL. Ninety-five percent of veterinarians agreed/strongly agreed that the model had adequate landmarks; only 5% disagreed that the model was appropriately realistic. All veterinarians responded that the model was suitable to teach and assess the skill. Students were similarly positive in their responses. Veterinarians were more accurate at diagnosing CCL stability (22/22 veterinarians vs. 44/56 or 79% students; p  < .05) and rupture (20/22 or 91% veterinarians vs. 39/56 or 70% students; p  < .05). Veterinarians’ survey responses (content evidence) and ability to detect CCL stability and rupture more accurately than students (evidence of a relationship with other variables) support validation based on this study's framework.