Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2017; 8(4): 290-294
Published online Apr 18, 2017. doi: 10.5312/wjo.v8.i4.290
Orthopaedic education in the era of surgical simulation: Still at the crawling stage
Kivanc Atesok, Peter MacDonald, Jeff Leiter, James Dubberley, Richard Satava, Ann VanHeest, Shepard Hurwitz, J Lawrence Marsh
Kivanc Atesok, Peter MacDonald, Jeff Leiter, James Dubberley, Department of Surgery, Section of Orthopaedic Surgery, University of Manitoba, Winnipeg, MB R3M 3E4, Canada
Richard Satava, Department of Surgery, University of Washington, Seattle, WA 98195-2840, United States
Ann VanHeest, Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN 55455, United States
Shepard Hurwitz, Department of Orthopaedic Surgery, University of North Carolina, Chapel Hill, NC 27514, United States
J Lawrence Marsh, Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA 52242, United States
Author contributions: All authors contributed to this manuscript.
Conflict-of-interest statement: We kindly indicate that we have no conflict of interest related to above entitled manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kivanc Atesok, MD, MSc, Sports Medicine and Upper Extremity Reconstruction Fellowship Program, Pan Am Clinic, Department of Surgery, Section of Orthopaedic Surgery, University of Manitoba, 75 Poseidon Bay, Room 229, Winnipeg, MB R3M 3E4, Canada. kivanc.atesok@utoronto.ca
Telephone: +1-204-9257480 Fax: +1-204-4539032
Received: October 15, 2016
Peer-review started: October 19, 2016
First decision: November 30, 2016
Revised: December 18, 2016
Accepted: January 11, 2017
Article in press: January 14, 2017
Published online: April 18, 2017

Surgical skills education is in the process of a crucial transformation from a master-apprenticeship model to simulation-based training. Orthopaedic surgery is one of the surgical specialties where simulation-based skills training needs to be integrated into the curriculum efficiently and urgently. The reason for this strong and pressing need is that orthopaedic surgery covers broad human anatomy and pathologies and requires learning enormously diverse surgical procedures including basic and advanced skills. Although the need for a simulation-based curriculum in orthopaedic surgery is clear, several obstacles need to be overcome for a smooth transformation. The main issues to be addressed can be summarized as defining the skills and procedures so that simulation-based training will be most effective; choosing the right time period during the course of orthopaedic training for exposure to simulators; the right amount of such exposure; using objective, valid and reliable metrics to measure the impact of simulation-based training on the development and progress of surgical skills; and standardization of the simulation-based curriculum nationwide and internationally. In the new era of surgical education, successful integration of simulation-based surgical skills training into the orthopaedic curriculum will depend on efficacious solutions to these obstacles in moving forward.

Keywords: Surgical simulation, Orthopaedic surgery, Education, Skills training

Core tip: Simulation-based surgical skills training outside the operating room has become essential for modern trainees due to restricted work-hours, cost pressures, emphasis on patient safety, and the increasing number of minimally invasive and technically challenging procedures. Orthopaedic surgery has fallen behind some other surgical specialties in integrating surgical simulation into its curriculum due to several obstacles. The authors aim to clarify these obstacles and suggest solutions for a smooth transformation to simulation-based curriculum in orthopaedic surgery.