The state of remote learning in plastic surgery: A systematic review of modalities

Abstract

Objective: To systematically review the published literature describing remote alternative educational modalities for plastic surgery residents.

Design: Systematic review.

Setting: Independent investigators performed searches in the PubMed and Cochrane Library databases using a variety of MeSH terms and search term combinations. These studies were evaluated for inclusion based on PRISMA criteria.

Participants: Literature searches were performed from June to December 2020, and articles were collected if they met the inclusion criteria. Studies were also qualitatively assessed to determine whether the described education modality demonstrated high fidelity (anatomic accuracy and similarity to true surgery) and efficacy (improved trainee performance in a standardized skills evaluation). Results: Initial database searches resulted in 2,849 total articles. Of these, 451 articles were deemed relevant for screening, and after applying additional exclusion criteria, 202 articles were assessed for eligibility. Of these, 66 articles met the inclusion criteria and were included in the qualitative synthesis. Articles were organized into three broad categories: physical models (n = 42, 63.7%), virtual simulators (n = 16, 24.2%), and online resources (n = 8, 12.1%). Among the physical models, we identified 15 high fidelity, 20 high efficacy, 5 high fidelity and high efficacy, and 2 high efficacy but low fidelity models. Among the virtual simulators, 6 demonstrated high fidelity, 8 high efficacy, and 2 demonstrated both values. Among the online resources, 3 showed high fidelity and 3 showed high efficacy.

Conclusions: A variety of remote training modalities have been published, including articles describing virtual surgical simulators, virtual and physical anatomic models, and online resources with video modules. Further investigation is needed to evaluate how effectively training received through remote means translates to practice in live clinical scenarios in the operating room.

Acgme competency addressed: Practice-based Learning and Improvement.

Keywords: Online education; Plastic surgery; Surgical models; Systematic review; Virtual simulation.

Fig. 1

PRISMA flowchart describing the process of article selection for inclusion in the literature review.