Simulation in Cleft Surgery

A number of digital and haptic simulators have been developed to address challenges facing cleft surgery education. However, to date, a comprehensive review of available simulators has yet to be performed. Our goal is to appraise cleft surgery simulators that have been described to date, their role within a simulation-based educational strategy, the costs associated with their use, and data supporting or refuting their utility.

The following PubMed literature search strategies were used: "Cleft AND Simulation," "Cleft Surgery AND Simulation," "Cleft Lip AND Simulation," "Cleft Palate AND Simulation." Only English language articles up to May 1, 2019, were included. Simulation phases of learning were classified based on our previously proposed model for simulation training.

A total of 22 articles were included in this study. Within identified articles, 11 (50%) were strictly descriptive of simulator features, whereas the remaining 11 (50%) evaluated specific outcomes pertinent to the use of cleft surgery simulators. The 22 included articles described 16 cleft surgery simulators. Out of these 16 cleft surgery simulators, 7 (43.8%) were high fidelity haptic simulators, 5 (31.2%) were low fidelity haptic simulators, and 4 (25.0%) were digital simulators. The cost to simulator user ranged from freely available up to $300.

Cleft surgery simulators vary considerably in their features, purpose, cost, availability, and scientific evidence in support of their use. Future multi-institutional collaborative initiatives should focus on demonstrating the efficacy of current cleft simulators and developing standardized assessment scales.