Editorial Commentary: Proficiency-Based Progression Surgical Simulation Training Is an Efficient Adjunct to High-Volume Clinical Experience.

Abstract

The optimal way to train a future surgeon has been debated for years, with strategies ranging from the well-known "see one, do one, teach one" approach to more novel approaches that rely on metrics and proficiency. Recent research shows that surgical training with a proficiency-based progression curriculum is an efficient strategy for teaching arthroscopy procedural skills, and, further, may improve patient safety by reducing the technical errors that might otherwise occur before proficiency is achieved. While every surgical specialty has its nuances that must be mastered to provide safe, effective, and efficient care, for a variety of reasons, the skills needed to perform arthroscopy are incredibly difficult to learn, let alone achieve proficiency or master. "On-the-job" training for orthopaedic residents has become more difficult in today's fast-paced, work hour-limited, volume-rewarded society. Proficiency-based progression is a piece of the puzzle, but for now, it is not a complete substitute for high-volume, clinical experience and exposure to the countless variables that may affect a "real-life" surgical procedure.