Manual Dexterity Training for Orthopaedic Residents - Non-Patient based Methodologies

Abstract

Current orthopaedic trainees are given less time to achieve competency in increasingly complex and diverse surgical procedures compared to their predecessors [1,2]. The multitude of different surgical techniques that have emerged require volumes of supervised repetition to achieve competence. It can be considered that surgical competence for orthopaedic residents cannot be achieved solely by caseload alone in the time it takes to complete residency [3,4]. Multiple factors, detrimental to the goal of rigorous training can be identified, including resident work hour restrictions, increasing administrative duties and documentation, inconsistent case volumes, and other service related duties [5]. These challenges have been compounded with changes in healthcare policies that center on Operating Room (OR) efficiency, reaching quality assurance targets, patient safety, and reducing patient waiting times. Such issues have forced a dramatic deviation from the traditional paradigm of the teacher-apprentice model of professional training, previously followed for the last hundred years [6]. These evolving challenges have necessitated alternative strategies of skill acquisition, notably physical and virtual simulation, psychomotor training, cognitive training, and competency-based evaluation.