Subscribe to RSS
The Use of an Inanimate Simulation Model for the Correction of an Anorectal Malformation in the Training of Colorectal Pediatric SurgeryFunding None.
Introduction An anorectal malformation (ARM) is a congenital malformation that requires surgical correction. To acquire the skills needed to perform this complex procedure, an affordable simulation model has previously been developed and validated. The aim of this study is to evaluate the suitability of this ARM model (with perineal fistula) for training in hands-on workshops.
Materials and Methods The ARM model consists of a wooden casing with disposable perineal body. Participants in several international pediatric colorectal hands-on workshops in 2019 and 2020 were asked to participate. They were divided in a target group and an experienced group based on experience. All practiced the posterior sagittal anorectoplasty procedure on the model with multimodality guidance. Subsequently, statements on the suitability of the model for use during hands-on workshops were scored on a 5-point Likert scale.
Results A total of 80 participants were included (43 surgical specialists, 13 pediatric surgery fellows, and 25 residents). Nearly, all statements scored at least a mean of >4.0, all scored significantly better than a neutral opinion. The target group (n = 58) scored higher compared with the experienced group (n = 22) on “transferability of the skills to the clinical setting” (means 4.4 vs. 4.0, p = 0.038); however, the “suitability as a replacement for an animal model” scored significantly lower (means 3.6 vs. 3.9, p = 0.049). No other differences were found.
Conclusion This affordable ARM model was regarded a suitable model for training during preclinical hands-on workshops and could be used for the specified steps of the procedure.
Keywordsinanimate simulation model - posterior sagittal anorectoplasty - anorectal malformation - simulation based training - hands-on workshop
Received: 12 October 2020
Accepted: 29 December 2020
10 February 2021 (online)
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Levitt MA, Peña A. Anorectal malformations. Orphanet J Rare Dis 2007; 2: 33
- 2 Peña A, Devries PA. Posterior sagittal anorectoplasty: important technical considerations and new applications. J Pediatr Surg 1982; 17 (06) 796-811
- 3 deVries PA, Peña A. Posterior sagittal anorectoplasty. J Pediatr Surg 1982; 17 (05) 638-643
- 4 van der Steeg HJ, Schmiedeke E, Bagolan P. et al. European consensus meeting of ARM-Net members concerning diagnosis and early management of newborns with anorectal malformations. Tech Coloproctol 2015; 19 (03) 181-185
- 5 Botden SMBI, Christie L, Goossens R, Jakimowicz JJ. Training for laparoscopic Nissen fundoplication with a newly designed model: a replacement for animal tissue models?. Surg Endosc 2010; 24 (12) 3134-3140
- 6 Mortell A, Montedonico S, Puri P. Animal models in pediatric surgery. Pediatr Surg Int 2006; 22 (02) 111-128
- 7 Evgeniou E, Loizou P. Simulation-based surgical education. ANZ J Surg 2013; 83 (09) 619-623
- 8 Dawe SR, Pena GN, Windsor JA. et al. Systematic review of skills transfer after surgical simulation-based training. Br J Surg 2014; 101 (09) 1063-1076
- 9 Palter VN, Grantcharov TP. Simulation in surgical education. CMAJ 2010; 182 (11) 1191-1196
- 10 Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: an ethical imperative. Simul Healthc 2006; 1 (04) 252-256
- 11 de Montbrun SL, Macrae H. Simulation in surgical education. Clin Colon Rectal Surg 2012; 25 (03) 156-165
- 12 Fonseca AL, Evans LV, Gusberg RJ. Open surgical simulation in residency training: a review of its status and a case for its incorporation. J Surg Educ 2013; 70 (01) 129-137
- 13 Cheng A, Lang TR, Starr SR, Pusic M, Cook DA. Technology-enhanced simulation and pediatric education: a meta-analysis. Pediatrics 2014; 133 (05) e1313-e1323
- 14 Marshall MB, Wilson BM, Carter YM. Thoracic surgery skill proficiency with chest wall tumor simulator. J Surg Res 2012; 174 (02) 250-256
- 15 Palter VN, Grantcharov T, Harvey A, Macrae HM. Ex vivo technical skills training transfers to the operating room and enhances cognitive learning: a randomized controlled trial. Ann Surg 2011; 253 (05) 886-889
- 16 Rintala RJ. Congenital anorectal malformations: anything new?. J Pediatr Gastroenterol Nutr 2009; 48 (Suppl. 02) S79-S82
- 17 Izawa Y, Hishikawa S, Muronoi T. et al. Ex-vivo and live animal models are equally effective training for the management of a penetrating cardiac injury. World J Emerg Surg 2016; 11 (01) 45-45
- 18 Radboudumc. Animal research facility - tariffs 2020. 2020 ;Radboudumcnl/research/animal-studies. Accessed July 8, 2020 at: https://www.radboudumc.nl/getmedia/2ce6b7ba-36d5-4643-9bb4-580d4cb0748c/Tariffs-2020.aspx
- 19 Pediatrickboxx. Accessed July 8, 2020 at: www.Pediatrickboxx.Com