Current Issues Faced by the Knee Surgical Trainee - Can Simulation Mitigate?

Description

The talk presents an in-depth discussion on the need for simulation in orthopedic surgical training, particularly in knee surgery. Delivered by Hannah James, a specialist registrar and honorary clinical lecturer, the presentation emphasizes two critical issues impacting surgical training: quantity and quality. It highlights a significant decline in operative experience for new consultants from 30,000 hours in 1990 to just 6,000 hours today, marking a five-fold reduction in just one generation. Furthermore, the quality of training is compromised as trainees spend more time on administrative duties rather than operating, with a striking 6:1 ratio of administrative tasks to actual surgical practice.



COVID-19 has further complicated these challenges, with reductions in surgical cases and disruptions to training. The speaker advocates for the use of simulation to enhance the learning curve for trainees, allowing them to progress more effectively from novice to expert in a controlled environment. Empirical studies demonstrate that simulation training improves performance metrics and competency in surgical procedures like arthroscopy and total knee arthroplasty. However, questions remain about the most effective types of simulation training and the timing for their implementation.



James also discusses the current state of simulation training in UK and Ireland orthopedic programs, revealing that while 80% have access to cadaveric laboratories, reliance on industry sponsorship for funding is common, creating disparities in access to training resources. The talk concludes by acknowledging the potential of simulation to improve surgical proficiency, while also calling for further research into effective training strategies and their subsequent transferability in real-world settings.

DOI: 10.1302/3114-210575

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