A 3D-printed endoscopic sinus surgery simulator – validity testing
Reviewed by Bhav Patel

The challenge of gaining sufficient experiential learning to successfully navigate the learning curve toward competence has long been a challenge in surgical education. The COVID-19 pandemic, and its impact on elective capacity, has presented a further challenge to the acquisition and development of skill. Simulation can play a role in enabling trainees to gain experience in a low-stakes environment. In this study, the authors assess the face, content, and construct validity of the PHACON Sinus Trainer. This trainer consists of a replaceable 3D-printed sinus module within a mannequin head. The authors recruited 12 residents to perform a number of surgical steps on the simulator and then subsequently on a cadaveric head. The face and content validity was assessed using questionnaires; the construct validity was assessed by comparing the performance of junior to senior trainees; the concurrent validity was assessed by comparing performance on the simulated head to the cadaveric head. The simulator was deemed to demonstrate face, content, concurrent, and construct validity. However, the participants felt improvements could be made, particularly with regards to the haptic feedback of the bony and mucosal tissue. This study demonstrates the potential educational value of a 3D-printed simulator. The success of any simulator lies in its ability to faithfully represent a concept, that has been abstracted from a real-world scenario in a different context. Reconsidering fidelity in terms of the relevance to the psychomotor demands of a clinical task (functional fidelity) as opposed to its physical resemblance to the patient (structural fidelity) may be more productive for the development of effective simulation tools. The 3D-printed sinus module is the component of this simulator that provides the functional fidelity to enable experiential learning. Thus, the development and refinement similar 3D-printed modules, though an open-source approach, would enable a low-cost, high-utility approach to surgical simulation.

Validity testing of a three‐dimensionally printed endoscopic sinonasal surgery simulator.
Alwani MM, Svenstrup TJ, EH Bandali, et al.
LARYNGOSCOPE
2020;130(12):2748-53.