Assessment of procedural skills using virtual simulation remains a challenge

Area of Science:

• Surgical simulation
• Medical education technology
• Laparoscopic surgery training

Background:

• The LAP Mentor is a procedural simulator designed for stepwise laparoscopic cholecystectomy training.
• Assessing the construct validity of surgical simulators is crucial for their effective implementation in training.

Purpose of the Study:

• To evaluate the construct validity of the LAP Mentor simulator by assessing its ability to differentiate between surgical skill levels.
• To determine if the LAP Mentor can discriminate between experts, residents, and novices in laparoscopic cholecystectomy performance.

Main Methods:

• Three groups (experts, residents, novices) performed cholecystectomy exercises and a full procedure on the LAP Mentor.
• Performance was assessed based on quantity (time, movements) and quality (accuracy) metrics.
• Statistical analysis included Kruskal-Wallis and Mann-Whitney U tests.

Main Results:

• Experts outperformed novices in quantitative aspects of cholecystectomy exercises.
• The full procedure demonstrated significant differences across all quantitative parameters (except speed) between the three groups.
• Quality of performance, specifically "accuracy rate of dissection," showed significant improvement only in one exercise for experts.

Conclusions:

• The LAP Mentor's full procedure exhibits sufficient discriminative power for construct validity.
• The simulator's current lack of quality control renders it unsuitable for assessing procedural laparoscopic skills.
• Further research is needed to clarify the LAP Mentor's role in surgical training.