(vii) Role of Computer Assisted Surgery (CAS) in Training and Outcomes

Training in orthopaedic surgery, as in other specialities, is facing a great dilemma as new regulations in most countries limit the number of training hours for new trainees.In this paper, we briefly overview the new regulations and their impact on training schemes in the UK but they are also applicable to other countries tackling similar issues. We reiterate the ethical principles that set the limits beyond which training would be neither acceptable nor safe. We also review the evidence in the literature that suggests that Computer Assisted Surgery (CAS) could help in training and answer the problems concerning both training regulations and ethical constraints. We focus our review on CAS as a surgical guiding tool rather than as a simulation technology. Several aspects are evaluated: reduction of learning curve, improving cognitive skills, immediate feedback, accuracy and precision in surgical techniques and the educational role of CAS. It seems that CAS fulfils the criteria in assisting trainees and trainers with new regulations without impinging on the ethical principles. However the ultimate role of CAS in training still needs to be assessed. Finally we explore the role that CAS could play in the Patient Reported Outcome Measures (PROMS).