International validation of the animal tissue model for training hypospadias repair

Urology fellowship training alone is insufficient to master hypospadias surgery. Simulation-based education is promoted, but well-validated models are unavailable. This study aims to validate the animal-tissue model for face, content, construct and concurrent validity and assess its suitability for future hypospadias training.

Sixty-four paediatric surgeons and seven medical students from seven centres participated in a 3-h didactic course including frontal lectures with hands-on-training to perform a tubularized incised plate repair. Training was conducted using the animal tissue model, composed of lamb and dorsal-hooded chicken skin. Trainees completed questionnaires assessing face, content and concurrent validity. Construct validity was determined through supervisor ratings.

84.4% of surgeons rated the model as realistic with 87.5% recommending training on the model prior to operating on humans. Improvement of surgical skills after a single training session have been reported by 87.5% of surgeons. The model is considered easily reproducible by 90.6% of surgeons and suitable for both home-based and workshop training by 78.1%. Students and beginners achieved lower objective performance scores, supporting construct validity and integration into future Objective Structured Assessment of Technical Skills (OSATS) courses. Compared with other training models, the animal tissue model was rated as the most suitable simulator available. (median score 1-2 vs. 3-4.5; 1 - totally suitable, 5 - not at all suitable).

Validation across face, content, construct, and concurrent criteria supports implementation of the animal tissue simulator for future training. Trainees consider the model as the most suitable platform available.