From the Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada (Dr. Lohre and Dr. Goel); the Massachusetts General Hospital-Boston Shoulder Institute, Boston, MA (Dr. Warner); the Department of Orthopaedic Surgery, University of Texas Health San Antonio, San Antonio, TX (Dr. B. R. Morrey); the Western University, Schulich School of Medicine and Dentistry, London, ON, Canada (Dr. Athwal); the Mayo Clinic Department of Orthopaedic Surgery, Rochester, MN (Dr. M. E. Morrey); and the Department of Orthopaedic Surgery, UConn Health, Farmingham, CT (Dr. Mazzocca).
J Am Acad Orthop Surg Glob Res Rev. 2021 Oct 12;5(10):01979360-202110000-00010. doi: 10.5435/JAAOSGlobal-D-21-00193.
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.
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.
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.
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.
COVID-19 大流行打乱了外科医生和受训者的骨科培训结构。在非选择性实践活动期间，必须考虑技能衰退的概念。本研究的目的是提供一个循证课程，与沉浸式虚拟现实（iVR）相关联，以防止培训停止期间和之后的技能下降。
对骨科手术技能衰退的相关文献进行了回顾。从多个具有虚拟培训经验的机构收集了教职员工和住院医师和研究员计划主任的早期经验，包括 iVR。从定性叙事小组意见中提出了一个在 COVID-19 期间进行认知和手动技能获取的课程。
技能衰退可能在几天到几个月的时间内发生，并且取决于初始技能水平。根据基于能力的课程标准，从专家意见和最佳现有证据技术和课程结构中得出了一个用于外科手术中断期间和之后的结构化继续医学教育的新型课程，包括电子学习、虚拟会议和 iVR 模拟器。
技能衰减缓解策略应使用满足高级学习概念的最佳现有证据技术和课程结构。包括 iVR 模拟器在内的虚拟课程可能为培训提供具有成本效益的解决方案。
