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Surgical simulation validity studies are increasing, but most use outdated frameworks. This review highlights the need for contemporary validity frameworks in assessing technical skills across surgical specialties.

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Area of Science:

  • Medical Education
  • Surgical Simulation
  • Assessment Validity

Background:

  • Validity evidence is crucial for reliable surgical skill assessment.
  • Surgical simulation is widely used for training and evaluation.
  • Current assessment tools require robust validity evidence.

Purpose of the Study:

  • To identify trends in validity frameworks for surgical simulation.
  • To review evidence for technical skill assessment in surgery.
  • To provide guidelines for future validity studies.

Main Methods:

  • Systematic literature review of 5 databases (2008-2017).
  • Included original studies on simulation-based assessments in surgical specialties.
  • Qualitative synthesis of data on validity frameworks and study characteristics.

Main Results:

  • 498 studies with 18,312 participants were analyzed.
  • Publications on validity assessments in surgical simulation more than doubled.
  • Only 6.6% used the contemporary Messick framework; outdated frameworks were common.

Conclusions:

  • Validity evidence for surgical simulation is growing but often relies on outdated frameworks.
  • Significant differences exist across surgical specialties.
  • Guidelines are provided for implementing contemporary validity frameworks in future studies.