Enhancing paediatric endoscopic airway training with a high-fidelity 3D-printed simulator

To develop and validate a high-fidelity, low-cost paediatric airway simulation model for endoscopic procedures, replicating a range of laryngeal pathologies. The study assessed the model's face, content, and construct validity and evaluated its educational value for airway surgery training.

A prospective, multicentre validation study was conducted across three international paediatric otolaryngology courses. Eighty otolaryngologists of varying seniority completed a 19-item Likert questionnaire assessing face and content validity for laryngomalacia, subglottic stenosis and laryngeal cyst models. A subgroup of registrars undertook repeated supraglottoplasty practice to assess construct validity through performance scores and completion time.

All 80 participants completed validation surveys. Mean face and content validity scores exceeded 4/5 across all models, indicating strong anatomical fidelity and educational value. The simulator was rated highly for improving endoscopic technique (mean content score 4.79 ± 0.41). In the construct validity subgroup, supraglottoplasty completion time improved by 7.54m (t = 3.55, p = 0.01) with skill scores increasing by +1.25 points (t = -3.56, p = 0.01). Junior trainees showed greater improvement than seniors. Participants provided favourable qualitative feedback on realism and instrument handling.

This modular, 3D-printed paediatric airway simulator demonstrates face, content and construct validity, with reproducible educational benefits across an international cohort. Its low cost, modularity and interchangeable inserts supports scalable adoption in training programmes. Future work should assess transferability of skills to clinical practice and optimise tissue fidelity for improved haptic realism.