Hands-on Training in a Virtual World: Novel Simulation-based Virtual Training for Subdermal Contraceptive Implant Placement and Removal


      The COVID-19 pandemic necessitated a shift from traditional face-to-face instruction for new technical skills to virtual delivery of medical education training. Our objectives were to develop and validate a virtual simulation training program for Canadian healthcare professionals (HCPs) on the insertion, localization, and removal of the etonogestrel subdermal contraceptive implant.


      A scientific committee of Canadian family planning experts developed a two-part virtual training program during the COVID-19 pandemic. In Part 1, core educational content was provided in an asynchronous, self-directed, on-line format. Part 2 consisted of synchronous, simulation-based training using web conferencing. HCPs were provided with model arms and training placebo applicators, trainers demonstrated implant insertion/removal techniques, and trainees received individual feedback on technical performance. All trainees were asked to complete an on-line evaluation upon program completion.


      Between March 2020 and June 30, 2021, 2130 Canadian HCPs had completed Parts 1 and 2 of the training program and 1275 participants completed the program evaluation (response rate 60%). Participants reported high levels of satisfaction with virtual simulation-based training. Ninety-seven percent (1229/1275) of participants agreed the virtual format was effective. Four percent (51/1275) requested additional training prior to inserting the implant in clinical practice.


      Virtual simulation-based learning provides effective education and technique training for etonogestrel implant insertion and removal. Online delivery of implant training can be scaled to use as needed to reach professionals in remote or underserved locations and for training provision of other technical or surgical procedures.


      simulation-based training; contraceptives; virtual learning