key: cord-266842-fr7kj186 authors: McKechnie, Tyler; Levin, Marc; Zhou, Kelvin; Freedman, Benjamin; Palter, Vanessa; Grantcharov, Teodor P. title: Virtual Surgical Training During COVID-19: Operating Room Simulation Platforms Accessible from Home date: 2020-05-01 journal: Ann Surg DOI: 10.1097/sla.0000000000003999 sha: doc_id: 266842 cord_uid: fr7kj186 nan the past several decades, there remain a number of options for the maintenance of intraoperative knowledge beyond textbook-learning that are easily accessible from home. Computer-and phone-based technologies provide access to intraoperative video recordings, virtual reality (VR) operating room simulations, and other interactive surgical platforms. Such applications are widely available and have the potential to satisfy and supplement the learning needs of surgical trainees as defined by surgical education governing bodies. 2 Moreover, surgical simulation has the potential to increase objective technical proficiency in the operating room, decrease intraoperative errors, and decrease operative time. 3 The aim of the present article is to provide an overview of the available computerand phone-based platforms accessible at home for surgical trainees who currently have limited surgical exposure given the ongoing COVID-19 pandemic. Such a review may allow surgical trainees as well as surgical education governing bodies to initiate and create at-home surgical curricula during the COVID-19 pandemic. Exponential growth of computer processing power over recent decades has fueled a parallel expansion of computer-based surgical platforms. Currently, over 20 computer-based platforms, ranging over nine surgical specialties, are available on the internet and are accessible from home. Fifteen computer-based platforms are freely accessible, one platform (Incision Academy) is offering a four-week free trial during the COVID-19 pandemic, and seven platforms require paid accounts. subscribe. 4 It has been demonstrated that residents with an active subscription to SCORE Portal score higher on their American Board of Surgery Qualifying Examination. 5 The Journal of Medical Insight (JOMI) is a peer-reviewed surgical video journal that offers annotated intraoperative videos along with supporting primary literature, organized neatly into "chapters". Each chapter pertains to a specific step of the selected procedure, as well as offers an opportunity for self-assessment. Access to this platform costs $50 per month or $500 per year for surgical residents. Two platforms focus solely on General Surgery and six have content pertaining mostly to General Surgery while also having additional modules focused on other surgical specialties. Incision Academy is a European-based online platform that presents live intraoperative video. It details the steps of a given operation, provides primary literature evidence, allows for interactive anatomy learning relevant to the operation, and has a section for self-assessment. They have released a free four-week trial in light of the COVID-19 pandemic. WebSurg is an online platform that publishes multimedia General Surgery, as well as Gynecology, content monthly. It is produced by the Institute for Research into Cancer of the Digestive System (IRCAD, France) and is supported by Medtronic© and Karl Storz©. Over 2,000 sequenced and subtitled intraoperative videos in seven languages are currently available. This platform also offers free live webinars and conference broadcasts. Users must register a free online account for full access. Teach Me Surgery has a large General Surgery section as well as sections available for other surgical specialties. This is a free platform that organizes over 400 peer-reviewed articles, has over 1,000 interactive clinical images, and allows for self-assessment. Similarly, Surgery Squad caters to General Surgery, Ophthalmology, and Obstetrical procedures. It is an interactive, virtual reality platform that allows the user to progress through the key steps of an operation. Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. ensure material consolidation. Touch Surgery has been validated by 19 independent peerreviewed publications. For example, Touch Surgery laparoscopy and intramedullary femoral nail simulations were able to significantly distinguish between expert surgeons and novices (p<0.001, p<0.001). 8, 9 Additionally, studies have reported that users find the surgical simulations to be realistic. 8, 9 Level Ex developed four free interactive animated phone applications entitled Cardio Amidst the COVID-19 public health crisis, that has infected more than one million people in over 180 countries, the educational needs of surgical trainees should not be neglected. Promoting remote learning platforms such as those highlighted in the present review and integrating them into formal curriculum can expand educational opportunities beyond the walls of the hospital. Such measures may mitigate the diminished surgical skill among surgical trainees that is foreseeable in hospitals across the word. Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. COVID-19: Elective case triage guidelines for surgical care The role and validity of surgical simulation Surgical Simulation in 2013: Why is it still not the standard in surgical training? What can SCORE Web Portal usage analytics tell us about how surgical residents learn? Subscription to the Surgical Council on Resident Education Web Portal and qualifying examination performance Creation, implementation, and assessment of a general thoracic surgery simulation course in Rwanda Telemedicine for retinal care in developing nations: the ORBIS Cyber-Sight programme Validating Touch Surgery™: A cognitive task simulation and rehearsal app for intramedullary femoral nailing Validation of the mobile serious game application Touch Surgery™ for cognitive training and assessment of laparoscopic cholecystectomy Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited