The developing role of simulation within surgical training and the need for equitable access: a narrative review

Background: In recent years, surgical training has undergone considerable change and COVID-19 has accelerated the rate at which training methods have needed to be updated. Education of surgical trainees is now transitioning from that of a clinical setting to that of a simulated skills laboratory. This article aims to outline the importance of ensuring equitable access to high-fidelity surgical training equipment and to bring to attention the potential consequences of nonstandardized surgical simulation exposure. Methods: Data collection was performed using the PubMed, Ovid MEDLINE and Embase bibliographical databases with a predefined search strategy between 11 February 2021 and 1 June 2021. All articles considering surgical education via simulation technologies were considered. Results: Twentyeight studies were deemed eligible for inclusion in a qualitative synthesis. Despite the increasing popularity of simulation, simulation-guided learning has yet to become fully integrated within all curricula, and the use of these technologies is yet to be adequately evaluated in a post-pandemic context. Therefore, there is a need to educate and inform medical students and surgical trainees, who will all be required to learn from and be assessed on simulated clinical technologies. Conclusions: Surgical training methods must be consistently updated so that they reflect the transitioning cultural, social-economic, and political expectations and restraints on surgical curricula. Continual development of simulation facilities is required to ensure sustainable integration within surgical training. Equitable access for all trainees must be a future point of focus if surgical training is to continue at its current level.