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Construct validity of individual and summary performance metrics associated with a computer-based laparoscopic
Justin D Rivard1, Ashley S Vergis, Bertram J Unger
1Department of Surgery, St. Boniface General Hospital, University of Manitoba, 3rd Floor Z-Block, Winnipeg, MB, R2H 2A6, Canada, justindrivard@gmail.com.
Surgical Endoscopy
|January 21, 2014
Summary
Computer-based surgical simulators offer many metrics, but not all reflect true technical skill. This study validated specific metrics on the LapVR simulator, creating summary metrics that effectively differentiate skill levels for improved surgical education.
Area of Science:
- Medical Simulation
- Surgical Education Technology
- Skill Assessment
Background:
- Computer-based surgical simulators generate numerous performance metrics (e.g., speed, accuracy).
- The validity of these metrics in reflecting actual technical skill is often unconfirmed, potentially hindering educational effectiveness.
- This study aimed to validate performance metrics on the LapVR simulator.
Purpose of the Study:
- To assess the construct validity of individual performance metrics on the LapVR simulator.
- To identify which metrics reliably differentiate between novice, intermediate, and expert surgical skill levels.
- To develop task-specific summary metrics based on validated individual metrics.
Main Methods:
- 12 novices, 12 intermediates, and 11 experts performed four LapVR tasks (peg transfer, cutting, clipping, adhesiolysis) three times each.
- 36 individual metrics across six performance aspects were analyzed for their ability to discriminate between experience levels.
- Validated metrics were used to create summary equations for each task.
Main Results:
- Metrics related to time and motion path length were significant across all four tasks.
- A subset of individual metrics demonstrated significant differences between experience levels for each task.
- The developed summary metrics successfully distinguished between novice, intermediate, and expert surgical residents.
Conclusions:
- Not all metrics from surgical simulators are valid indicators of technical skill; educators should be discerning.
- The construct validity of specific individual metrics on the LapVR was established.
- Developed summary metrics offer a concise method for skill assessment per task, warranting further validation.
