Primer: cognitive motor learning for teaching surgical skill--how are surgical skills taught and assessed?

As the practice of surgery evolves, the modalities by which future surgeons are trained must also develop. Traditionally, surgical trainees have learned through a mentorship model, with the majority of cognitive motor learning for surgical skill being initiated and practiced within the operating room. This, however, is no longer the ideal environment in which to acquire surgical skills and, subsequently, many surgical training programs are incorporating the use of other surgical models within their curricula. Training on simulators, ranging from low-fidelity bench models to complex, high-fidelity virtual reality models, seems to be transferable and might prove to be a crucial supplement to the traditional curriculum. Models that are reliable and valid, coupled with objective instruments that measure technical skill, might prove to be useful for evaluation. For a simulator to provide a good assessment of competency, it should either correlate to or predict the person's technical performance in the operating room. More research is, therefore, needed regarding the validity and transferability of various training models, particularly if they are to become a form of assessment for certification or licensure.