Editorial Commentary: "A Brush Too Broad" (Validation, Global Rating Scales, and the Like…What Do They Really Mean?)

Surgical simulation will play an increasingly important role in helping to train surgical skills. Tools of varying fidelity including benchtop models and virtual reality computer-generated simulations will be needed to most effectively train for accomplishing specific tasks and techniques. We must search for and identify how best to employ simulation to enable the trainee to master the requisite skills. It is imperative that in our investigation, validation methodologies, rating scales, and statistical tools be rigorously and accurately employed lest we be led astray by acceptance and assumption too freely given. The measure of our effectiveness will be whether or not patients enjoy improved outcomes and experience a reduction in surgical errors and complications.