Objective Evaluation of Three-Dimensional Models for Training Congenital Cardiac Surgeons: A Systematic Review

Area of Science:

• Medical Education
• Surgical Simulation
• Cardiovascular Surgery

Background:

• Congenital cardiac surgery training faces challenges due to increasing case complexity and limited operative opportunities.
• Objective assessment tools are crucial for evaluating surgeon performance in simulated environments.
• Three-dimensional (3D) models offer a promising platform for surgical simulation and training.

Purpose of the Study:

• To systematically review objective assessment tools for surgeon performance in congenital cardiac surgical training using 3D models.
• To evaluate the types, validity, and outcomes of these assessment tools.
• To understand the impact of 3D model-based training on surgical skills and anatomical knowledge.

Main Methods:

• Systematic literature search of major databases (PubMed, Scopus, Web of Science, Embase) up to December 2025.
• Inclusion of original studies reporting objective assessments in congenital cardiac surgical training with 3D models.
• Adherence to PRISMA guidelines for systematic reviews.

Main Results:

• Nine studies met inclusion criteria, utilizing assessments like checklists, rating scales, and time-based measures.
• Simulation-based training with 3D models consistently improved technical performance, procedural accuracy, and reduced task completion time.
• Skill retention was observed in some studies; however, assessment of non-operative skills and operating room transferability was limited.

Conclusions:

• Objective assessment with 3D heart models provides a valid method for enhancing technical skills and anatomical comprehension in pediatric cardiac surgery.
• These models aid in procedural planning, anatomical exposure strategies, and structured skills acquisition.
• While not fully replicating operative complexity, 3D models are valuable in modern surgical training environments.