Systematic review of the current status of cadaveric simulation for surgical training

Background There is growing interest in and provision of cadaveric simulation courses for surgical trainees. This is being driven by the need to modernize and improve the efficiency of surgical training within the current challenging training climate. The objective of this systematic review is to describe and evaluate the evidence for cadaveric simulation in postgraduate surgical training. Methods A PRISMA‐compliant systematic literature review of studies that prospectively evaluated a cadaveric simulation training intervention for surgical trainees was undertaken. All relevant databases and trial registries were searched to January 2019. Methodological rigour was assessed using the widely validated Medical Education Research Quality Index (MERSQI) tool. Results A total of 51 studies were included, involving 2002 surgical trainees across 69 cadaveric training interventions. Of these, 22 assessed the impact of the cadaveric training intervention using only subjective measures, five measured impact by change in learner knowledge, and 23 used objective tools to assess change in learner behaviour after training. Only one study assessed patient outcome and demonstrated transfer of skill from the simulated environment to the workplace. Of the included studies, 67 per cent had weak methodology (MERSQI score less than 10·7). Conclusion There is an abundance of relatively low‐quality evidence showing that cadaveric simulation induces short‐term skill acquisition as measured by objective means. There is currently a lack of evidence of skill retention, and of transfer of skills following training into the live operating theatre. Antecedentes Existe un interés creciente en los cursos de simulación con cadáveres para la formación de residentes en cirugía, así como en aumentar la disponibilidad de dichos cursos. Ello es debido a la necesidad de modernizar y mejorar la eficiencia del entrenamiento en el marco actual del reto que supone la formación quirúrgica. El objetivo de esta revisión sistemática era describir y evaluar la evidencia del uso de la simulación con cadáveres en la formación quirúrgica de posgrado. Métodos Siguiendo la normativa PRISMA, se realizó una revisión sistemática de la literatura de estudios que evaluaban prospectivamente el entrenamiento quirúrgico mediante la simulación con cadáveres. Se realizaron búsquedas en todas las bases de datos relevantes y en registros de ensayos clínicos hasta enero de 2019. Se evaluó el rigor metodológico utilizando