Is Training With Animals Needed?

BACKGROUND: Live tissue training (LTT) has historically been an essential component of trauma training in surgery. Although surgical courses in Australia and Aotearoa New Zealand have transitioned away from LTT, some external specialised courses still incorporate animals for surgical training. Evidence on clinicians' perceptions and the effectiveness of surgical training courses involving animals was reviewed to better understand whether the continued use of LTT is appropriate. METHODS: A rapid review methodology was used to identify relevant literature in PubMed and Google Scholar. The results were synthesized narratively due to the broad scope and heterogeneous nature of the literature. RESULTS: Thirteen systematic reviews and nine qualitative studies were included. There were no clear differences between animal models and alternative simulation models in surgical training courses in terms of self-efficacy, validity, effectiveness, performance, or cognitive knowledge gained. Animal models were generally preferred for training purposes by neuro-interventionalists, endoscopists, paediatric surgeons, and military medical personnel. CONCLUSION: There was a lack of direct evidence for the benefits of LTT and ex vivo animal models over the many alternative simulation modalities available. In addition, no studies specifically linked learning outcomes to the use of LTT or provided any adequate justification for taking the educational benefits of LTT as tacit. Therefore, the use of live animal models in surgical training should only be considered after appropriate weighing of the moral costs involved in doing so and when their benefits clearly outweigh those of other simulation models in terms of educational outcome, ease of use, cost-effectiveness, and reusability.