Reply to Editorial Comment on “Hypospadias Reconstruction Training: Development of an Ex-Vivo Model for Objective Evaluation of Surgical Skills”

Abstract

W e sincerely appreciate the thoughtful feedback provided. The objective nature of the comments aligns closely with the goals of our work. As noted, this study1 was primarily aimed at evaluating technical skills in a hypospadias reconstruction model using EMG monitoring technology coupled with machine learning, which we believe presents a significant step forward in the objective assessment of surgical competence. Our primary aim was to assess skill acquisition across a wide range of experience levels, rather than focusing on a single group. This allowed us to explore how EMG data could capture measurable differences in skill gained from the course across different ranges of expertise. However, we acknowledge that the study was not specifically designed to delineate distinct trainee levels—novice, intermediate, or expert—which would further enhance the construct validity of the technology. We fully agree with your insightful observation that a future study focusing specifically on differences between trainees at various stages of training would add substantial value. Such research would enhance the use of EMG data in objectively assessing skill progression and readiness for independent practice. We are actively considering a follow-up study designed to address this aspect.