Does laparoscopic simulation predict intraoperative performance? A comparison between the Fundamentals of Laparoscopic Surgery and LapVR evaluation metrics

Am J Surg. 2015 Jan;209(1):34-9. doi: 10.1016/j.amjsurg.2014.08.031. Epub 2014 Oct 22.

Abstract

Background: Considerable resources have been invested in low- and high-fidelity simulators in surgical training. To our knowledge, no investigation has compared the 2 head to head for operative assessment purposes. The purpose of this study was to assess the Fundamentals of Laparoscopic Surgery (FLS) low-fidelity video trainer and LapVR (high-fidelity virtual-reality simulator) for (1) construct and (2) predictive validity using a human cholecystectomy model.

Methods: Twenty-six participants performed tasks from the FLS program and the LapVR simulator as well as a human laparoscopic cholecystectomy. Performance was evaluated using FLS and LapVR metrics and the Objective Structured Assessment of Technical Skills previously validated rating scale.

Results: Construct and predictive validity were strongly demonstrated for FLS tasks but only incompletely for LapVR.

Conclusions: Efforts should be focused on using the well-validated lower-cost FLS video trainer for assessment of laparoscopic skills. The high-cost LapVR remains experimental in resource-constrained training programs.

Keywords: Assessment; Education; Laparoscopic; Simulation; Surgery.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cholecystectomy, Laparoscopic / education*
  • Clinical Competence*
  • Computer Simulation*
  • Computer-Assisted Instruction / methods*
  • Female
  • Humans
  • Male
  • Manitoba
  • Models, Educational*
  • Multivariate Analysis
  • Reproducibility of Results
  • Task Performance and Analysis
  • User-Computer Interface*
  • Video Recording