Is live-tissue training ethically justified? An evidence-based ethical analysis

Bringing damage control surgery simulation to life: developing a novel surgical anatomy model within immersive military trauma surgery simulation

Haemorrhage from junctional injuries remains the most common cause of battlefield death. Changes to surgical training have meant acquiring and maintaining trauma surgical skills is becoming more difficult for military surgeons. The multidisciplinary Military Operational Specialist Team Training (MOSTT) course is designed to bridge the gap between civilian practice and the deployed environment, as part of predeployment trauma training. It involves immersive team simulation and uses cadaveric dissection for surgical skills practice.A novel surgical anatomy model, featuring junctional haemorrhage surgical task trainers of the groin and shoulder, was designed using reconstructed CT and MRI images obtained from a human volunteer. The model is designed to look and feel as realistic as possible, with the added dimension of pulsatile 'blood' flow from a simulation gunshot injury.This surgical anatomy model has been trialled, as part of the MOSTT course, by 90 surgeons and perioperative practitioners, with feedback analysis used for iterative model development. Feedback demonstrated that, alongside more traditional cadaveric dissection, this surgical anatomy model adds value to current predeployment training delivered within the immersive simulation of the MOSTT course. Research by the authors about the effects of this model on surgical ability and performance is ongoing. However, there is clear potential for this model to be used in other environments, including on exercises and as part of consolidation training while deployed.

The Educational Efficacy of Humane Teaching Methods: A Systematic Review of the Evidence

Humane alternatives to harmful educational animal use include ethically-sourced cadavers, models, mannequins, mechanical simulators, videos, computer and virtual reality simulations, and supervised clinical and surgical experiences. In many life and health sciences courses, however, traditional animal use persists, often due to uncertainty about the educational efficacy of humane alternatives. The most recent comprehensive reviews assessing learning outcomes of humane teaching methods, in comparison to harmful animal use, were published more than 10 years ago. Therefore, we aimed to collate and analyse the combined evidence from recent and older studies about the efficacy of humane teaching methods. Using specific search terms, we systematically searched the Web of Science, SCOPUS, and EMBASE databases for relevant educational studies. We extracted information on publication years, the country in which the study was conducted, field, humane teaching methods, form of learning outcome assessment, and the learning outcome of the humane teaching methods, in comparison with harmful animal use. We found 50 relevant studies published from 1968-2020, primarily stemming from the USA, UK, and Canada. Humane teaching methods produced learning outcomes superior (30%), equivalent (60%), or inferior (10%) to those produced by traditional harmful animal use. In conclusion, a wide-spread implementation of humane teaching methods would not only preserve learning outcomes, but may in fact be beneficial for animals, students, educators, and institutions.