Mitigating Surgical Skill Decay in Orthopaedics Using Virtual Simulation Learning.

J Am Acad Orthop Surg Glob Res Rev · Oct 12 2021 · Review

Lohre R, Warner JJP, Morrey BR, Athwal GS, Morrey ME, Mazzocca AD, et al.

From the Department of Orthopaedics, University of British Columbia, Vancouver, CT (Dr. Mazzocca)

General Orthopaedics

SUMMARY — THE REDUCTIONVirtual reality simulation can mitigate surgical skill decay during training cessation; structured curriculum combining e-learning, virtual meetings, and immersive VR simulators provides cost-effective solution.
Abstract, as published

BACKGROUND: The COVID-19 pandemic has interrupted orthopaedic training structures for both surgeons and trainees. The concept of skill decay must be considered during inactivity of elective practice. The purpose of this study was to provide an evidence-based curriculum in association with immersive virtual reality (iVR) to prevent skill decay during periods of training cessation and beyond.

METHODS: A review of pertinent literature for orthopaedic surgical skill decay was performed. Early experience by faculty instructors and residency and fellowship program directors was gathered from multiple institutions with experience in virtual training methods including iVR. A proposed curriculum for cognitive and manual skill acquisition during COVID-19 was produced from qualitative narrative group opinion.

RESULTS: Skill decay can occur on the order of days to months and is dependent on the initial skill level. A novel curriculum for structured continuing medical education during and after periods of surgical disruption including e-learning, virtual meetings, and iVR simulators was produced from expert opinion and based on competency-based curriculum standards.

CONCLUSION: Skill decay mitigation strategies should use best available evidence technologies and course structures that satisfy advanced learning concepts. The virtual curriculum including iVR simulators may provide cost-effective solutions to training.

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