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J Am Acad Orthop Surg. 2016 Aug;24(8):505-14. doi: 10.5435/JAAOS-D-15-00440.

Retention of Skills After Simulation-based Training in Orthopaedic Surgery.

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From the Section of Orthopaedic Surgery, Department of Surgery and the Sports Medicine and Upper Extremity Reconstruction Fellowship Training Program, Pan Am Clinic, University of Manitoba, Winnipeg, Manitoba, Canada (Dr. Atesok), the Department of Surgery, University of Washington Medical Center, Seattle, WA (Dr. Satava), the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN (Dr. Van Heest), the Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA (Dr. Hogan, and Dr. Fu), the Department of Orthopaedic Surgery, University of California, Los Angeles, CA (Dr. Pedowitz), the Department of Perioperative Services, Mt. Sinai Hospital, New York, NY (Ms. Sitnikov), the Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA (Dr. Marsh), and the Department of Orthopaedic Surgery, University of North Carolina School of Medicine, Chapel Hill, NC (Dr. Hurwitz).


Simulation-based surgical skills training has become essential in orthopaedic practice because of concerns about patient safety and an increase in technically challenging procedures. Surgical skills training in specifically designed simulation laboratories allows practice of procedures in a risk-free environment before they are performed in the operating room. The transferability of acquired skills to performance with patients is the most effective measure of the predictive validity of simulation-based training. Retention of the skills transferred to clinical situations is also critical. However, evidence of simulation-based skill retention in the orthopaedic literature is limited, and concerns about sustainability exist. Solutions for skill decay include repeated practice of the tasks learned on simulators and reinforcement of areas that are sensitive to decline. Further research is required to determine the retention rates of surgical skills acquired in simulation-based training as well as the success of proposed solutions for skill decay.

[Indexed for MEDLINE]

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