The role of low-fidelity simulation in paediatric endoscopic training: Build your own

Abstract

Non-animal simulation models can allow trainees to practice the key steps and skills required for laparoscopic procedures outside the tightly controlled setting of specific simulation labs and courses. Here, we set out to describe and disseminate how one can build a laparoscopic ureteric reimplantation and pyeloplasty model at home for training, using simple materials and evaluate its value for training. We have developed two plastic- and silicone-based models for simulating laparoscopic pyeloplasty, and used it for training at the BAPES Scholarship Advanced Minimal Access Surgery Urology Course. We received both quantitative and qualitative feedbacks from both trainers and trainees. When rating the course 1–5 (1 not useful, 5 useful), candidates gave median scores of 4 for the simulation usefulness, transferability of skills, and realism. With the reimplantation model, candidate scores for all three areas improved familiarity (mean 3.2–4.8, P < 001), confidence (1.9–3.3, P < 0.001), and competence (1.8–3.8, P < 0.001). With the laparoscopic pyeloplasty model; confidence (3.2–4.2, P < 0.001) and competence (3.4–4.1, P < 0.001) increased. Qualitative data from candidates and trainers were positive, specifically when rating the models' realism and its use for teaching the surgical steps. Low-fidelity models have a key role for surgical training. Establishing key surgical steps and through being more easily accessible for trainees, they offer a valid and useful alternative to high-fidelity simulation.