Surgical simulation education in plastic surgery: current state of the art and need for improvement

: Simulation tools continue to play an important part in surgical education, particularly allowing junior trainees an opportunity to familiarize themselves with various procedures that they either have not been exposed to or have not had enough repetition to feel confident enough to execute. It is particularly relevant when surgical training is interrupted due to unforeseen circumstances (i.e., coronavirus disease 2019, also called COVID-19) or to personal reasons (i.e., pregnancy, leave of absence). The ability to remotely work on technical skills has tremendous value and is certainly one of the reasons that we have continued to develop new surgical simulation tools, particularly in the field of plastic surgery. A review of the major surgical simulation and anatomy software tools available within the various subdivisions of plastic surgery such as craniofacial, microsurgery, aesthetic, hand/upper extremity and burn was performed. We also reviewed some of the simulation tools available in other surgical specialties and evaluated them for fit and utility in plastic and reconstructive surgery (PRS) surgical education. Our study shows that while various surgical simulators have been developed in PRS over the years, there remains a gap in terms of the ability for residents and trainees to acquire real-life skills remotely along with the capability to receive live feedback from faculty. This review shows that further tools need to be developed to optimize the acquisition and maintenance of surgical skills in a remote fashion. Taken together, it provides an overview of the evolution of surgical simulation education within plastic surgery.