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Design and validation of a novel low-cost open paediatric inguinal herniotomy simulator
Tanay Bapna1, Samuel J A Robinson1,2, Damir Ljuhar1
1Department of Paediatric Surgery & Monash Children's Simulation, Monash Children's Hospital, 246 Clayton Road, Clayton, Melbourne, 3168, Australia.
Insights
A new low-cost simulator for open pediatric inguinal hernia repair was developed. It shows good content and construct validity, proving useful for training surgical trainees in this common procedure.
Area of Science:
- Medical Education
- Surgical Simulation
- Pediatric Surgery
Background:
- Simulation-based education is crucial in pediatric surgery.
- Inguinal hernias are common in infants (1-5% incidence).
- Limited simulators exist for open pediatric inguinal hernia repair.
Purpose of the Study:
- To create and validate a novel simulator for pediatric open inguinal hernia repair.
- To assess the simulator's face, content, and construct validity.
- To evaluate its functional task alignment for surgical trainees.
Main Methods:
- Developed a low-cost simulator for open pediatric inguinal herniotomy.
- Recruited novices (medical students) and experts (pediatric surgeons).
- Assessed validity using Likert-scale questionnaires and procedural error analysis.
Main Results:
- Simulator showed favorable content validity (e.g., useful for trainees: 7.0/10.0, logical flow: 9.0/10.0).
- Novices made significantly more errors than experts, demonstrating construct validity (p=0.02).
- Lower scores for face validity (tissue/visual realism) and expert utility (2.0/10.0).
Conclusions:
- The developed simulator possesses content and construct validity.
- It demonstrates a high degree of functional task alignment for open pediatric inguinal herniotomy training.
- This low-cost tool is a valuable addition for surgical trainees.
Background:
Simulation-based education is a valuable tool in paediatric surgery. Inguinal hernias are a common paediatric surgical presentation with an incidence of 1-5% in full-term infants. While previous simulators have been created for adult inguinal hernias and laparoscopic paediatric inguinal hernias, there are limited models for the open paediatric procedure. We aimed to create and validate a simulator for a paediatric open inguinal hernia repair.
Methods:
Essential procedural steps of an open inguinal herniotomy were determined, and a low-cost paediatric simulator was developed. Novices (medical students) and experts (paediatric surgeons) were recruited. A questionnaire on an 11-point Likert-type scale assessed face validity, content validity, and functional task alignment. Median scores > 7.0/10.0 were deemed valid. The total number and type of procedural errors were assessed to determine construct validity. Statistical analysis included Fisher's exact test, a p-value < 0.05 was considered significant.
Results:
A total of 34 participants were recruited (expert:10, novice:24). The simulator received favourable median scores in the following content validity domains: useful for surgical trainees (7.0/10.0), useful to train open surgical skills (7.5/10.0), and logical flow of procedural steps (9.0/10.0). It was not deemed a valuable training tool for experts (2.0/10.0). The simulator had median scores below 7.0/10.0 for face validity domains, including its tissue and visual realism. Construct validity was demonstrated by novices making more errors on the simulator, p = 0.02.
Conclusions:
This low-cost open inguinal herniotomy simulator demonstrated content validity, construct validity, and a high degree of functional task alignment.
