Hands-on Distance Simulation of Technical Skills: A Systematic Review

Distance simulation in health care has advanced rapidly, offering potential to reduce geographical barriers, costs, and carbon emissions while increasing global access to medical education. This systematic review evaluated hands-on technical skills training via distance simulation compared to traditional on-site training. Following PRISMA guidelines, 104 studies were analyzed. Laparoscopic skills, suturing, and ultrasound were the most studied tasks. Distance simulation, using decentralized portable simulators and centralized telementoring, demonstrated comparable or superior outcomes to on-site training. However, only 2 studies assessed skill transfer to clinical settings, and 1 reported patient-related outcomes. Rigorous randomized controlled trials (RCTs) are needed to further evaluate skill retention and clinical impact.