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Farinha et al. Mini-invasive Surg 2023;7:38  https://dx.doi.org/10.20517/2574-1225.2023.50                                                                              Page 9 of 14


                              Table 4. Kane framework

                                         Proposed use (decision)             (Type of) Scoring                        Generalization Extrapolation                           Implications

                              Hidalgo    Develop and test an in-vivo porcine LPN   Use time as a metric in different steps  None identified  The model enhances the learning experience Participants endorsed application of the
                                  [16]
                              et al.     TM to teach LPN                                                                                                                     model as an effective surgical educational
                                                                                                                                                                             tool
                              Yang       Develop and test an ex-vivo porcine LPN   Used operation-specific and time metrics   None identified  Trainees found the model helpful, increased   Authors consider the model useful for
                                  [32]
                              et al.     TM to teach LPN                     Measured learning curve and quality of PN               confidence, and improved skills in LPN  learning key steps of PN and developing
                                                                                                                                                                             advanced laparoscopic suture-repairing
                                                                                                                                                                             skills
                              Hung       Evaluate face, content, and construct   Used questionnaires to assess realism and   None identified  Experts rated the model high in realism and   A model appropriate for resident and fellow
                                  [18]
                              et al.     validities of ex-vivo RAPN TM       utility as training tools                               as a training tool for residents and fellows.   training
                                                                             Video recordings were assessed by three                 Limited training role for expert surgeons
                                                                             experts
                                                                             Use time, operation-specific metrics, and
                                                                             GOALS
                              Chow       Assess validity and effectiveness of an   Used time and GEARS                None identified  Improved skills, shortened the learning curve,  Use of this model in a urology residency
                                  [11]
                              et al.     ex-vivo porcine TM                  Video recorded performances                             and increased operator confidence       curriculum
                                                                             Blinded assessors
                              Fernandez   Evaluate the materials model for PN   Likert-scale to rate quality and realism of   None identified  Rated as “good” realism       PVA-C use was less expensive and entailed
                                  [20]
                              et al.     kidney tumors                       renal tumor model                                       Participants considered the model helpful in   fewer logistic concerns than those
                                                                             Evaluated operation-specific and time metrics           learning to perform LPN                 associated with the animal model
                                                                             Evaluated learning curve measuring time                 Good teaching tool for residents and fellows
                                                                                                                                     to learn technical skills of the LPN
                              Golab      Create individual silicone models for   Used time as metrics                 None identified  Improved actual surgery               Producing these models brings new
                                  [25]
                              et al.     training LPN                                                                                Reduced the need for/duration of        possibilities for laparoscopic education
                                                                                                                                     intraoperative renal ischemia
                              Monda      Assess face, content, and construct   Evaluated usefulness and realism of the model  None identified  Experts gave high ratings for realism and   Novel and economic methods of
                                  [19]
                              et al.     validity of a RAPN training model   as a training tool,                                     usefulness                              manufacturing silicone models
                                                                             Performance measured using operation-                   Differentiated surgical performance of   Useful for trainees to gain fundamental
                                                                             specific metrics, NASA-TLX and GEARS                    groups’ expertise                       surgical skills in RALPN
                                                                             Video performance recorded and blinded                  Evidenced learning curve
                                                                             assessments by experts
                              Ghazi      Simulation platform for RAPN        Used CROMS and GOALS                     None identified  Rated by experts as superior to porcine or   The model might lead to widespread use of
                                  [21]
                              et al.                                         Evaluated realism ratings and training                  cadaveric models for replication of     procedural, patient-specific, individualized
                                                                             effectiveness                                           procedural steps                        practice
                                                                                                                                     Excellent at discriminating experts from   No need for dedicated teaching robots and
                                                                                                                                     novice performance                      wet-laboratory facilities
                              Maddox     Develop patient-specific kidney models   No scoring.                         None identified  Patients who underwent the preoperative   Use of this type of model may decrease the
                                  [26]
                              et al.     for the purpose of pre-surgical resection  Compare clinical results between patients        surgical model experienced lower estimated  slope of the learning curve and improve
                                         and incorporation into simulation labs  from the study and similar studies from a           blood loss at the time of resection     patient outcomes
                                                                             RAPN database
                              von        Develop patient-specific pre-surgical   Compare resection times between the model  None identified  Improved resection times        Can assist in surgical decision-making,
                              Rundstedt   simulation protocol for RALPN      and the actual tumor in a patient-specific              Similar morphology and tumor volumes when  provide preoperative rehearsals, and
                                  [27]
                              et al.                                         manner                                                  compared with the real tumor            improve surgical training
                                                                                                                                     Predict feasibility of RALPN within an
                                                                                                                                     acceptable ischemia time
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