A systematic review of simulators for kidney transplantation surgical training

INTRODUCTION: Simulation-based training is increasingly recognized as a cornerstone of surgical education, aiming to improve technical skills while reducing risks for patients. In kidney transplantation, however, simulation remains poorly explored, and the validity and educational value of available models are unclear. MATERIALS AND METHODS: A systematic literature search was performed in PubMed, Embase, Cochrane Library, and Google Scholar from inception until December 31, 2024. Studies in English and French reporting on kidney transplantation simulators were included. Two independent reviewers screened titles, abstracts, and full texts, with disagreements resolved by discussion. Data were extracted on study design, simulator characteristics, validation methods, outcomes, and biases. RESULTS: The search identified 3343 records, of which 8 studies met the inclusion criteria. Three focused on robot-assisted transplantation and five on open transplantation. Most publications described the development or construction of simulators rather than their validation. Three studies evaluated participant satisfaction through questionnaires, and two assessed technical performance using validated rating scales. However, other domains of validity-including content, construct, concurrent, and predictive validity-as well as educational impact were not formally assessed in any study. Overall, the methodological quality was low, with small sample sizes, heterogeneous evaluation methods, and no comparators. CONCLUSION: The literature on kidney transplantation simulators remains limited. Existing studies focus largely on describing model development rather than providing robust validation or demonstrating educational benefit. Future research should emphasize standardized validation frameworks and structured evaluation to define the role of simulators in transplantation training.