76 - The McMaster Embalming Scale (MES): Continued Validation for the Assessment of Embalming Solutions for Surgical Skills Training

Poster Board Number: 76
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Odd poster #s – first hour
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Abstract Body : Introduction
Surgical skills training on high-fidelity models is a universal method for developing competency in surgical residents that allows for learning in a controlled setting without the risk and time constraints of the operating theater. A literature review was conducted and indicated that training on cadaveric material is an excellent high-fidelity simulation that improves trainees’ confidence and decreases the time needed for skill acquisition. A variety of soft-preservation solutions exist which allow cadavers to maintain joint flexibility and tissue textures which are more life-like. Because of a lack of standardized methods to assess their suitabilities for surgical skills, the McMaster Embalming Scale (MES) was developed to assess the visual, tactile, and overall characteristics of tissues embalmed using various preservation solutions.

Objective
This study follows the work conducted by Le et al., which developed and pilot tested the MES on porcine tissues. A study using human cadavers is to be conducted in February 2023 to further validate the psychometric properties of the MES in the evaluation of embalming solutions on this type of surgical training model. The four highest-scoring embalming solutions from the pilot experiment were selected to be further evaluated to assess the capacity of the MES to investigate and distinguish between their utility.

Materials and Methods
Four human cadavers donated through the McMaster Bequeathal Program will be embalmed using either Surgical Reality Fluid©™, saturated salt solution, an ethanol-based solution, or the Imperial College London soft preservation solution. Forty-eight participants will be recruited via the Surgical Foundations program at McMaster University. Residents will be conducting three surgical skills, which will allow for the utility of the MES to capture the suitability of each solution. The skills include electrocautery, chest tube insertion and anchoring, and bone drilling and sawing. A set of fully crossed data will be collected and analyzed using similar statistical analyses conducted in the pilot experiment. To allow for the further assessment of the MES’ validity and reliability, statistical testing will follow a similar format to that of the pilot study including a generalizability study, scale domain to overall score correlation and inter-rater reliability.

Results
The results for this study will be collected in February 2023 during a surgical skills session. Ratings for each of the seven domains of the MES will be collected including tissue decay, odor, color, visual fidelity, the force required to conduct a skill, tissue texture, and overall suitability.

Significance
Training on cadaveric models provides surgical trainees an opportunity to practice in an environment conducive to skill acquisition and mastery. The MES provides institutions with a standardized method of comparing embalming solutions to provide learners with models that best suit this purpose.

Conclusions
The results of this study will provide further insights on the reliability and validity of the MES. A valid scale will provide an objective assessment tool for cadaver-based medical education.