Supplementary Material for: Comparison of Mannequin Training Satisfaction with a Conventional Box Trainer and a Low-Fidelity Fetoscopic Surgical Simulator for Selective Fetoscopic Laser Photocoagulation

<b><i>Background:</i></b> A low-fidelity fetoscopic surgical simulator (FSS) for training of selective fetoscopic laser photocoagulation (SFLP) was developed. <b><i>Objective:</i></b> To evaluate and compare training satisfaction with an FSS and with a conventional box trainer (BT). <b><i>Methods:</i></b> The BT consisted of a cleaned human placenta attached to the inside of a plastic storage box with a watertight lock cover and an ultrasound-transparent rubber skin. The FSS consisted of the replica of a monochorionic twin placenta attached to the inside of a spherically shaped, ultrasound-transparent phantom. Tap water was used as an ultrasound conduction agent. Evaluation of the mannequin trainings was conducted on 8 junior maternal-fetal medicine (MFM) attending physicians and 22 MFM fellows. Training satisfaction was scored from 0 to 10 on 8 different domains. <b><i>Results:</i></b> The mean satisfaction score (±SD) with the FSS was higher than with the BT in all domains (<i>p</i> &lt; 0.05). The fellows’ training satisfaction with the BT was greater than that of the attending physicians in 4 domains: tactile feedback, demonstration of chorionic vessels, feedback on performance, and overall value as learning aid (<i>p</i> &lt; 0.05). <b><i>Conclusions:</i></b> As evaluated by a small group of trainees, our FSS is superior to the BT in mannequin training of SFLP. However, the BT may be more useful for trainees with limited clinical experience.