Table 1.

A summary of the main simulation modalities available to orthopaedic surgery trainees

Simulation model	Advantages	Disadvantages
Cadaveric simulation		Expensive
	High fidelity	Not easily accessible with specialist storage demands
		Time-consuming preparation time
	Shown to develop transferable operative skills	Relies on tissue donation
		Risk of disease transmission
	Allows understanding of relevant clinical anatomy and surgical approaches	Lack of uniformity amongst specimens
Synthetic bone simulation	Relatively inexpensive, portable and widely available
	Widely available	Does not allow understanding of influence of soft tissues
	Develop understanding and familiarity with orthopaedic instruments and equipment	Lack of true haptic feedback
Arthroscopic simulation	Able to record progress and assess motion analysis
	Allows for development of hand-eye co-ordination and triangulation	High initial setup costs
	Wide range of procedures may be possible	Limited realism
	Modern simulators can provide haptic feedback
Virtual reality simulation	Able to record progress and assess motion analysis
	Wide range of procedures may be possible	High initial setup costs
	Allows for scenario simulation
Cognitive simulation	Potentially cost free	Limited evidence to support use in clinical training/improvement in technical procedural skills
	Accessible on mobile devices
	Point of care education