Validated simulation models in pediatric surgery: A review

Joosten, Maja; Blaauw, Ivo de; Botden, Sanne M. B. I.

doi:10.1016/j.jpedsurg.2022.06.015

Cited by 5 publications

(4 citation statements)

References 63 publications

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“…It could be reasonable to assume that more complex tasks, such as intracorporeal suturing, might be better suited for distinguishing between intermediate and expert surgeons ( 18 ). Several models for training in minimally invasive surgery (MIS) esophageal atresia (EA) repair have been documented in the literature ( 13 ). The majority of these models are inanimate, but there is an exception with the model described by Barsness et al, which involved an inanimate casing combined with fetal bovine tissue to replicate the organs involved in EA with tracheoesophageal fistula (TEF) repair ( 27 , 28 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, research suggests that increased realism in a simulator doesn't necessarily correlate with improved learning outcomes. This prompts questions about the justification of the added costs associated with high-fidelity simulators, especially when comparable knowledge and skill outcomes can be attained with more budget-friendly alternatives ( 13 , 14 ). The objective of this study was to introduce and validate an inexpensive, reusable inanimate model designed for training in the thoracoscopic repair of EA/TEF.…”

Section: Introductionmentioning

confidence: 99%

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Inanimate 3D printed model for thoracoscopic repair of esophageal atresia with tracheoesophageal fistula

Zahradniková,

Babala,

Pechanová

et al. 2023

Front. Pediatr.

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BackgroundThoracoscopic repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF) poses significant technical challenges. This study aimed to develop an inexpensive, reusable, high-fidelity synthetic tissue model for simulating EA/TEF repairs and to assess the validity of the simulator.MethodsBy using 3D printing and silicone casting, we designed an inexpensive and reusable inanimate model for training in thoracoscopic EA/TEF repair. The objective was to validate the model using a 5-point Likert scale and the Objective Structured Assessment of Technical Skills (OSATS) to evaluate participants' surgical proficiency.ResultsA total of 18 participants (7 medical students, 4 pediatric surgery trainees, and 7 experienced surgeons), after being instructed and trained, were asked to perform TEF ligation, dissection, as well as esophageal anastomosis using six sliding knots on the EA/TEF simulator. All participants in the expert group completed the task within the 120-minute time limit, however only 4 (57%) participants from the novice/intermediate completed the task within the time limit. There was a statistically significant difference in OSATS scores for the “flow of task” (p = 0.018) and scores for the “overall MIS skills” (p = 0.010) task distinguishing between novice and intermediates and experts. The simulator demonstrated strong suitability as a training tool, indicated by a mean score of 4.66. The mean scores for the model's realism and the working environment were 4.25 and 4.5, respectively. Overall, the face validity was scored significantly lower in the expert group compared to the novice/intermediate groups (p = 0.0002).ConclusionsOur study established good face and content validity of the simulator. Due to its reusability, and suitability for individual participants, our model holds promise as a training tool for thoracoscopic procedures among surgeons. However, novices and trainees struggled with advanced minimally invasive surgical procedures. Therefore, a structured and focused training curriculum in pediatric MIS is needed for optimal utilization of the available training hours.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inanimate 3D printed model for thoracoscopic repair of esophageal atresia with tracheoesophageal fistula

Zahradniková,

Babala,

Pechanová

et al. 2023

Front. Pediatr.

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“…While these are very innovative solutions for surgical training and assessment, surgical simulators have two current issues: availability and validity evidence. Joosten et al wrote a systematic review examining the validity of simulators mentioned in the literature [38]. Of the 38 models reported in the literature, only 5 models are commercially available and 11 models were replicable based on the article description.…”

Section: Simulation Models and Trainersmentioning

confidence: 99%

Advances in Pediatric Surgery Simulation-Based Training

Knowlin,

Laskay,

Jules

et al. 2023

Children

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Pediatric surgery is the diagnostic, operative, and postoperative surgical care of children with congenital and acquired anomalies and diseases. The early history of the specialty followed the classic “see one, do one, teach one” philosophy of training but has since evolved to modern methods including simulation-based training (SBT). Current trainees in pediatric surgery face numerous challenges, such as the decreasing incidence of congenital disease and reduced work hours. SBT consists of several modalities that together assist in the acquisition of technical skills and improve performance in the operating room. SBT has evolved to incorporate simulator models and video gaming technology, in parallel with the development of simulation in other surgical and non-surgical pediatric fields. SBT has advanced to a level of sophistication that means that it can improve the skills of not only pediatric surgery trainees but also practicing attending surgeons. In this review, we will discuss the history of pediatric surgery, simulation in pediatric surgery training, and the potential direction of pediatric surgical simulation training in the future.

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“…2) The use of cadavers [12], which involves low availability, a high preparation cost, and a signi cant bioethical con ict, is not an acceptable resource for everyone. 3) The use of simulation models, built with different synthetic materials [13][14][15]. The marked industrialization and technological progression we are experiencing are contributing to lowering the design and production costs of these models and making their generalization for the training of Paediatric Surgeons possible.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a realistic neonatal intestinal atresia simulator for the training of pediatric surgeons

Montero,

Asfura,

Riveros

et al. 2024

Preprint

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Background Neonatal surgical pathology presents high technical complexity and few opportunities for training. Many of the neonatal surgical entities are not replicable in animal models. The use of realistic 3D models is a cost-effective and efficient alternative for the training of new generations of pediatric surgeons. Methods We conceptualized, designed, and produced an anatomically realistic model for the open correction of jejunoileal atresia. We validated it with two groups of participants (experts and non-experts) through face, construct, and content validity questionnaires. Results The model was validated by 11 experts and 9 non-experts. The mean procedure time for the experts and non-experts groups was 41 and 42 minutes respectively. Six non-experts and one expert did not complete the procedure at the designed time (45 minutes) (p = 0.02). The mean score of face validity was 3.1 out of 4. Regarding construct validity, we found statistically significant differences between groups for the correct calculation of the section length of the antimesenteric border (Nixon's technique) (p < 0.01). Concerning content validity, the mean score was 3.3 out of 4 in the experts group and 3.4 out of 4 in the non-experts group. Conclusions The present model is a realistic and low-cost valid option for the training of open correction of jejunoileal atresia. Future studies with larger sample sizes and blinded validators are needed before drawing definitive conclusions.

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Validated simulation models in pediatric surgery: A review

Cited by 5 publications

References 63 publications

Inanimate 3D printed model for thoracoscopic repair of esophageal atresia with tracheoesophageal fistula

Inanimate 3D printed model for thoracoscopic repair of esophageal atresia with tracheoesophageal fistula

Advances in Pediatric Surgery Simulation-Based Training

Development and validation of a realistic neonatal intestinal atresia simulator for the training of pediatric surgeons

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