The Evidence Basis for Learning Theory and Technology in Surgical Skills Training.

Orthopaedic trainees face a complex and challenging training environment that is currently becoming more competency driven. Associated with these changes are an increasing introduction and use of a variety of technologically driven surgical training augments. Although these new learning resources can positively transform the educational environment, they must be used appropriately by both learners and educators. To aid in this, we review learning theories because they apply to surgical skills training and highlight recent surgical training evidence that demonstrates how technology use can be optimized to promote surgical learning, with an emphasis on procedural learning theory and cognitive load theory. Specifically, we review the evidence demonstrating the importance of targeting technology to a learner's experience level and methods to optimize cognitive load by managing intrinsic load, minimizing extraneous load, and maximizing germane load.