Human cadavers used for surgical training are embalmed using various methods to facilitate tissue storage and longevity while preserving the natural characteristics required to achieve high fidelity functional task alignment. However, there are no standardized means to evaluate the suitability of embalming solutions for this purpose. The McMaster Embalming Scale (MES) was developed to assess the extent to which embalming solutions allow tissues to achieve physical and functional correspondence to clinical contexts. The MES follows a five‐point Likert scale format and evaluates the effect of embalming solutions on tissue utility in seven domains. This study aims to determine the reliability and validity of the MES by presenting it to users after performing surgical skills on tissues embalmed using various solutions. A pilot study of the MES was conducted using porcine material. Surgical residents of all levels and faculty were recruited via the Surgical Foundations program at McMaster University. Porcine tissue was unembalmed (fresh‐ frozen) or embalmed using one of seven solutions identified in the literature. Participants were blinded to the embalming method as they completed four surgical skills on the tissue. After each performance, participants evaluated their experience using the MES. Internal consistency was evaluated using Cronbach's alpha. Domain to total correlations and a g‐study were also conducted. Formalin‐fixed tissue achieved the lowest average scores, while fresh frozen tissue achieved the highest. Tissues preserved using Surgical Reality Fluid (Trinity Fluids, LLC, Harsens Island, MI) achieved the highest scores among embalmed tissues. The Cronbach's alpha scores varied between 0.85 and 0.92, indicating a random sample of new raters would offer similar ratings using the MES. All domains except odor were positively correlated. The g‐study indicated that the MES is able to differentiate between embalming solutions, but an individual rater's preference for certain tissue qualities also contributes to the variance in scores captured. This study evaluated the psychometric characteristics of the MES. Future steps to this investigation include validating the MES on human cadavers.

Introduction Competency Based Medical Education, overseen and implemented by the Royal College of Physicians and Surgeons of Canada, requires realistic simulation of specific tasks called Entrustable Professional Activities (EPAs). Mastery of these tasks is required to proceed in the surgical specialty. Due to the growing need for high fidelity training in postgraduate surgical education, there has been a shift from the use of hard‐fixed to soft‐fixed material for improved realism. Currently, there exists no standardized way of assessing the suitability of various fixation techniques for different EPAs. Objective The current study seeks to establish the most appropriate tissue fixation method for each EPA. Additionally, we aim to develop a standardized matrix to rate the effectiveness of soft‐fixation methods for the purposes of surgical training based on a number of factors such as the EPA, storage, longevity, biohazardous risk, cost, biomechanical properties, and realism. Hypothesis We hypothesize that different soft‐fixation methods possess varying suitabilities for each EPA, which could be deduced through the use of a testing matrix. Methods EPAs will be performed on cadaveric tissues embalmed with various soft‐fixation solutions. In order to establish the solutions that will be used, initial tests will be conducted on porcine material. Each pork hock (the joint between the tibia/fibula and the metatarsals) will be embalmed with one of 8 soft‐fixation solutions. Surgical residents will perform an EPA on each embalmed tissue and record their observations. The residents will respond to statements about each of the embalming solutions using a 5‐point Likert scale. The results from this testing will be used to select the embalming solutions to be used when the study is conducted on human donors. Results Testing of porcine material to determine the most useful fixation technique is expected to be completed in February of 2022. Testing on cadaveric tissue is expected to be completed in July of 2022. Conclusion Gaining an understanding of the suitability of various soft‐fixation methods allows for high fidelity surgical skills training and the maximization of the use of each donor.