Related Experiment Video
Updated: Oct 17, 2025
Utilizing a 3D Printed Laparoscopic Nissen Fundoplication Model to Shorten a Resident's Learning Curve
Published on: August 15, 2025
Mitigating Surgical Skill Decay in Orthopaedics Using Virtual Simulation Learning
Ryan Lohre1, Jon J P Warner, Bernard R Morrey
1From 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).
Background:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
