ABSTRACT
Introduction: Simulated training in Pediatric Surgery/Urology is gaining significance due to the following reasons: (a) being a specialty of rare diseases affects individual surgeon's exposure to index cases;(b) subspecialty areas are not universally accessible;and (c) Covid-19 affected elective surgery. Consequently, targeted training, via workshops and simulated models, is necessary. Hypospadias is the index case/operation in Pediatric Urology, requiring a spectrum of dissection and reconstruction skills. It is further challenging to revisit and redo, thus sound initial repair is crucial. To date, there has been no successfully utilizable 3D-printed hypospadias model. We hereby present our experience with silicone 3D-printed high-fidelity hypospadias models. Method(s): Overall, 27 trainees from different countries, under the supervision of 15 instructors, completed the training exercise. They were all given a seminar to show the relevant anatomy and eight key steps of the exercise. Each trainee filled a structured assessment form for the quality of the exercise and resemblance to live surgery. Each exercise was evaluated by a trainer on-site, who supervised the activity and two independent assessors through photographs of the cardinal steps. Result(s): In total, 11 (40.7%) trainees had 1-3 years of specialist training experience, 10 (37%) had 4-6 years, and 6 (22.2%) had beyond. Meanwhile, 2 (7.4%) trainees had no hypospadias experience, 16 (59.2%) assisted in procedures or performed steps, 5 (18.5%) performed whole procedures with guidance, and 4 (14.8%) without guidance. The trainees rated each step from unsatisfactory (1/5) to excellent (5/5) for each of the (1) degloving;(2) urethral marking;(3) incision;(4) tubularization;(5) glanuloplasty;(6) dartos layer preparation;(7) preputioplasty, and (8) skin closure. However, 20 (74%) trainees and 15 (100%) instructors judged the model to resemble the anomaly. Meanwhile, 17 (63%) trainees and 13 (86.6%) instructors rated needle penetrability of the material compared to human tissue >= 3/5. In total, 16 (59%) trainees and 13 (86.6%) instructors rated suture holding >= 3/5. Moreover, 11 (73.3%) and 13 (86.6%) instructors rated sutures' evenness and edge cooptation >= 3/5. Conclusion(s): Majority of instructors found this 3D-model able to mediate transferring skills. Trainees reported adequate skill acquisition.