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--- jnl:atesok2016 [2019/05/17 08:10]
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+++ jnl:atesok2016 [2020/03/24 02:34] (current)
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 ====Commentary====
-  * The article starts with usual reasons for adopting simulation
+  * This review article starts with usual reasons for adopting simulation
   * It discusses the importance of transferability and retention
   * Transferability has been shown in orthopaedic simulation, but is affected by variables
@@ Line 15: / Line 15: @@
       * short-term (up to 3 months), and
       * long-term (3 months to years).
-  * "The goal of simulation-based courses should be to make training to proficiency levels quicker and safer than with traditional methods, not necessarily to make sur- geons expert in the long term"
+    * Few studies in Orthopaedics
+      * Casts ([[jnl:Sonnadara2011]] and [[jn:Sonnadara2012]])
+      * Arthroscopy
+        * Shoulder
+        * Meniscal repair (Jackson)
+      * Decay is variable: Shoulder yes, knee meniscal no -- perhaps depends on the task and learner? It is context and task specific
+        * Studies from other specialties over long term suggests that you must use the skills or they will deteriorate
+  * "The goal of simulation-based courses should be to make training to proficiency levels quicker and safer than with traditional methods, not necessarily to make surgeons expert in the long term"
+===Table 1 (which is available online and I included as a sample below) provides a summary of Studies on Retention of Skills After Simulation-based Training in Specialties Other Than Orthopaedic Surgery ===
+^Study  ^ No. of Subjects  ^Skill ^ Assessment ^ Follow-up Time ^ Results and Critical Notes ^
+|Stefanidis et al17 |15; Simulator group (n = 11) versus control group (n = 4)|Laparoscopic suturing |Performance scored on the basis of time and errors| immediate and 5mo | The simulator group had better performance than did the control group at both immediate and 5mo tests (P ,0.001). The simulator group performance deteriorated at 5 mo in the absence of practice (P ,0.05). No further training or surgical exposure occurred in either group during follow-up.|
+=== Other Notes===
+  * [[co:Spaced Learning]] or practice helps retention. Article suggests "spaced rehearsal", increasing the amount of time between practices (much like the idea behind flash cards).
+  * Use of simulation as "warm up" or "rehearsal". Rehearsal with simulator before test improved laryngeal mask insertion.
+  * lapse in practice does cause decay in skills learnt in a simulator. Tasks that are more difficult to learn decay faster
+  * There is a need: "Program directors of orthopaedic surgery residency programs in the United States think that formal skills training is important at the junior level. In a 2013 survey, most program directors indicated that the primary learners for skills training were ortho- paedic junior residents (95%) and orthopaedic senior residents (70%).39"
+  * Is boot-camp style concentrated practice (i.e. massed learning), better than longitudinal experience (spaced learning)?
+  * ABOS does not currently assess surgical competency: "Independent external evaluation of surgical skills is not included in orthopaedic board certification; however, the ABOS is assessing mechanisms to develop and validate surgical skills tests as part of this process."
 ====Source====
 Atesok, K., Satava, R. M., Van Heest, A., Hogan, M. C. V., Pedowitz, R. A., Fu, F. H., … Hurwitz, S. R. (2016). Retention of skills after simulation-based training in orthopaedic surgery. Journal of the American Academy of Orthopaedic Surgeons, 24(8), 505–514. https://doi.org/10.5435/JAAOS-D-15-00440

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