Validity and fidelity in the context of live animal training in surgical education

Abstract Validity and fidelity are medical education concepts that characterise how well a simulated learning event maps onto real practice. Surgical simulation for educational purposes is not a new phenomenon, but despite advances in technology, the use of live anaesthetised animals as simulator models persists. Within surgical training, while live animal simulation may be considered to be “high-fidelity”, it should not necessarily be regarded as having validity as an educational method. This article aims to more fully describe the concepts of validity and fidelity in the context of simulation for surgical education and considers the current status of validity assessment. Finally, the balance between the educational and ethical challenges that arise when medical educators design simulated learning activities for surgeons is reviewed. There remains an undue emphasis on fidelity, and an underutilised process of validation in surgical simulation education, both of which have been used to defend the use of live animals. Yet, a specific choice of simulator will never be as important as the decision of how it is used for learning.