{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T12:12:31Z","timestamp":1778069551901,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Surgical Research Trust, New Zealand."}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Minimally invasive surgical (MIS) skills are increasingly expected of surgical trainees; however, opportunities to practice these outside the operating theater are limited. Current pediatric surgery trainees have limited exposure to thoracoscopic repair of esophageal atresia (OA\/TOF) during their training. We evaluated the utility of a neonatal OA\/TOF simulator for the acquisition and retention of MIS skills amongst surgical trainees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Randomized controlled cross-over trial of 20 surgical trainees in New Zealand. Participants were block-randomized into two groups: SIM versus NO-SIM groups. Each group had 12 weeks of access to the take-home Symulus neonatal OA\/TOF simulator before crossover. During the intervention period, participants practiced three MIS tasks in a self-directed manner: ring transfer (RT), needle pass (NP), and anastomotic suture (AS). Modified objective structured assessment of technical skills (OSATS) scores were recorded at baseline, mid-point, and study completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      OSATS scores were highest for the RT task, followed by NP and AS tasks. A significant increase in OSATS scores was observed for the NP (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .017) and AS tasks (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). The SIM group, who had earlier access to the simulator, appeared to outperform the NO-SIM group at all time points, although this difference did not reach statistical significance. While the RT and NP scores converged over time, the AS scores (representing a higher level of skill) diverged over time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our analysis demonstrates the effectiveness of this OA\/TOF simulator in facilitating the acquisition and retention of MIS skills via self-directed learning. These findings support the integration of similar surgical simulators into current training programs to enhance MIS skill acquisition in a low-risk, accessible setting; particularly for those procedures where the complexity is high, but the frequency of cases is low.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261428659","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T16:39:52Z","timestamp":1773247192000},"page":"477-482","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Portable Neonatal Esophageal Atresia Simulator Improves MIS Acquisition Amongst Surgical Trainees: A Randomized Control Crossover Trial"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0302-3465","authenticated-orcid":false,"given":"Georges Kamil","family":"Tinawi","sequence":"first","affiliation":[{"name":"Department of Paediatric Surgery, Christchurch Hospital, Canterbury, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella Natalie","family":"Alexandra","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Christchurch Hospital, Canterbury, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Reeves","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Christchurch Hospital, Canterbury, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spencer W.","family":"Beasley","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Christchurch Hospital, Canterbury, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan M.","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Christchurch Hospital, Canterbury, New Zealand."},{"name":"Christchurch Simulation Centre, University of Otago, Christchurch, New Zealand."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-025-06095-7"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.04.016"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12411"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2016.0249"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2019.05.022"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2022.06.015"},{"issue":"1","key":"e_1_3_3_8_1","first-page":"34","article-title":"Advances in pediatric surgery simulation-based training","volume":"11","author":"Knowlin LT","year":"2023","unstructured":"7.Knowlin LT, , Laskay NMB, , Jules NP, et al. Advances in pediatric surgery simulation-based training. Children (Basel) 2023;11(1):34.","journal-title":"Children (Basel)"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.11.019"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2021.03.054"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11517-019-02107-6"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2020.0637"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2022.01.029"},{"key":"e_1_3_3_14_1","volume-title":"Symulus Thoracoscopic EA\/TEF Surgical Simulator","author":"Symulus","year":"2025","unstructured":"13.Symulus. Symulus Thoracoscopic EA\/TEF Surgical Simulator. Symulus; 2025."},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800840237"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.yjpso.2024.100180"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2004.02.006"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11548-022-02793-y"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2014.0364"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2014.0358"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2009.01.040"}],"container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429261428659","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10926429261428659","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10926429261428659","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:18:47Z","timestamp":1778066327000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10926429261428659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6,1]]}},"alternative-id":["10.1177\/10926429261428659"],"URL":"https:\/\/doi.org\/10.1177\/10926429261428659","relation":{},"ISSN":["1092-6429","1557-9034"],"issn-type":[{"value":"1092-6429","type":"print"},{"value":"1557-9034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]}}}