Current Status of Simulation in Thoracic Surgical Training.

BACKGROUND: Simulation is playing an increasingly important role in surgical training but is not yet a mandatory part of most surgical curricula. A simulator must undergo rigorous validation to verify it as a reliable tool. The aim of this study was to review the literature to identify simulators that are currently available to augment thoracic surgical training and analyse any evidence supporting or validating them. METHODS: A literature search of the MEDLINE® (1946 to November 2022) and EMBASE® (1947 to November 2022) databases was performed to identify simulators for basic skills and procedures in thoracic surgery. A selection of keywords were used to perform the literature search. After identification of appropriate articles, data were extracted and analysed. RESULTS: Thirty-three simulators were found in thirty-one articles. Simulators for basic skills (n=13) and thoracic lobectomy (n=13) were most commonly described, followed by miscellaneous (n=7). The majority of models were of a hybrid modality (n=18). Evidence of validity was established in 48.5% (n=16) of simulators. In total, 15.2% (n=5) of simulators had three or more elements of validity demonstrated and only 3.0% (n=1) accomplished full validation. CONCLUSIONS: Numerous simulators of varying modality and fidelity exist for a variety of thoracic surgical skills and procedures, although validation evidence is frequently inadequate. Simulation models may be able to provide training in basic surgical and procedural skills, however further assessment of validity needs to be undertaken prior to consideration of their integration into training programmes.