Abstract
OBJECTIVE
Unilateral biportal endoscopic spine surgery (UBE) offers several advantages over traditional techniques but is associated with a steep learning curve and limited access to structured training. Simulation-based education may facilitate skill acquisition, however, validated training platforms for UBE remain limited. This study aimed to develop and validate a porcine simulation model for UBE lumbar decompression and evaluate its educational impact using established simulation validity frameworks.
METHODS
A prospective educational study was conducted at the University of Ottawa between October 2025 and April 2026. Thirty-six participants with varying levels of surgical experience completed a structured curriculum consisting of baseline assessment, instructional training, and posttraining evaluation. Performance was assessed using a 7-point Likert-based global rating scale and task completion time across 3 standardized tasks. Face, content, and construct validity were evaluated through participant questionnaires and performance comparisons. Pre- and posttraining performance was analyzed using paired statistical tests. Univariate and multivariate linear regression analyses were performed to identify predictors of baseline performance.
RESULTS
Twenty-seven participants completed both pre- and posttraining assessments; 35 participants contributed baseline data for construct validity analysis. The simulator demonstrated high face and content validity, with median Likert scores of 6–7. Construct validity was supported by significantly higher baseline performance among advanced participants compared with novices across all tasks (task 1 combined total score, p = 0.003; task 2, p = 0.007; task 3, p
CONCLUSIONS
The porcine UBE simulation model represents a cost-effective training platform with established face, content, and construct validity and produces measurable short-term improvements in simulator performance after a single structured session. This model provides a practical approach to support structured training in UBE spine surgery. Predictive validity, long-term skill retention, and whether simulation-acquired skills shorten the operative learning curve remain hypotheses for future study.