Validation of an operating room immersive microlaryngoscopy simulator

Area of Science:

• Medical Simulation
• Surgical Education
• Otolaryngology

Background:

• Microlaryngoscopy requires specialized training and objective assessment tools.
• Existing assessment methods for surgical simulators may lack comprehensive validation.
• High-fidelity simulators offer a safe environment for developing surgical skills.

Purpose of the Study:

• To evaluate the face and construct validity of two novel assessment tools for a microlaryngoscopy simulator.
• To compare the reliability and differentiating ability of the Checklist Assessment for Microlaryngeal Surgery (CAMS) and the Global Rating Assessment for Microlaryngeal Surgery (GRAMS).
• To determine the suitability of these tools for otolaryngology training programs.

Main Methods:

• A blinded, experimental, simulator-based study involving 15 otolaryngology candidates (novice and experienced).
• Participants performed a 10-minute microlaryngoscopy and excision biopsy simulation.
• Two blinded experts rated performances using CAMS and GRAMS; candidates completed a face validity questionnaire.

Main Results:

• The microlaryngoscopy simulator demonstrated good face validity.
• GRAMS showed excellent interrater reliability (0.9) but did not differentiate between novice and experienced surgeons.
• CAMS demonstrated construct validity by differentiating candidate experience levels (interrater reliability 0.7).

Conclusions:

• This study introduces the first validated, task-specific rating tools for a high-fidelity microlaryngoscopy simulator.
• GRAMS is recommended for frequent feedback in otolaryngology training.
• CAMS is recommended for confirmatory competency evaluations during training transitions.