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Hands-on Distance Simulation of Technical Skills: A Systematic Review
Wei Wei1, Martine S Nielsen, Anders B Nielsen
1Department of Anesthesiology (W.W., Y.H.), Eye & ENT Hospital of Fudan University, Shanghai, China,Copenhagen Academy for Medical Education and Simulation (CAMES) (W.W., L.K., K.M.C.), Rigshospitalet, Capital Region of Denmark, Copenhagen, Denmark,University of Copenhagen, Faculty of Health Sciences (W.W., L.R., L.K., K.M.C.), Copenhagen, Denmark,Department of Anesthesiology and Intensive Care (M.S.N.), Lillebælt University Hospital, Kolding, Denmark,Research Unit of Medical Education (M.S.N., A.B.N.), University of Southern Denmark, Odense, Denmark,Department of Anesthesiology and Intensive Care (A.B.N.), Odense University Hospital, Svendborg, Denmark; and Department of Anesthesia and Intensive Care (L.R), Copenhagen University Hospital Gentofte, Hellerup, Denmark.
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Distance simulation in health care has advanced rapidly, offering potential to reduce geographical barriers, costs, and carbon emissions while increasing global access to medical education. This systematic review evaluated hands-on technical skills training via distance simulation compared to traditional on-site training. Following PRISMA guidelines, 104 studies were analyzed. Laparoscopic skills, suturing, and ultrasound were the most studied tasks. Distance simulation, using decentralized portable simulators and centralized telementoring, demonstrated comparable or superior outcomes to on-site training. However, only 2 studies assessed skill transfer to clinical settings, and 1 reported patient-related outcomes. Rigorous randomized controlled trials (RCTs) are needed to further evaluate skill retention and clinical impact.
