COVID pandemic

• A novel virtual world programme with over 240 multiple choice questions was developed to assess the competencies in managing an open fracture of the lower limb according to the British Orthopaedic Association Standards for Trauma (BOAST) and Advanced Trauma Life support (ATLS) guidelines.
• A longitudinal, observational, multi-centre prospective cohort study was conducted at Imperial College London.
• Primary objective consisted of objective scores calculated in real-time from the 240 multiple choice questions between Novices, Intermediates and Experts.
• Participants who had either completed ATLS training, or had familiarised themselves with BOAST guidelines were also identified and correlated with objective scores.

This is a multi-centre prospective randomised controlled educational trial observing for validity and training effect of managing an orthopaedic emergency using a virtual patient within an online world. Cohorts consist of junior, intermediate and expert surgeons being tested on 240 multiple choice questions to assess for competency as well as face, content and construct validity.

Inclusion Criteria:

• Postgraduate orthopaedic trainees and naïve to surgical simulation

Exclusion Criteria:

• undergraduates and previous exposure to surgical simulation involving cognitive task analysis

Postgraduate orthopaedic trainees and Attendings/Consultants