Validation of an endoscopic flavectomy training model

Area of Science:

• Minimally Invasive Spine Surgery
• Surgical Simulation
• Medical Education Technology

Background:

• Endoscopic spine surgery, particularly flavectomy, requires specialized skills.
• Objective validation of surgical simulators is crucial for effective medical training.
• The construct method is a recognized approach for simulator validation.

Purpose of the Study:

• To validate a novel lumbar spine endoscopic flavectomy simulator using the construct method.
• To evaluate the simulator's acceptability and utility in medical education.
• To assess its ability to differentiate between novice and experienced surgeons.

Main Methods:

• Thirty medical students and ten experienced orthopedists performed endoscopic flavectomy on the simulator.
• Performance metrics included procedure time, look-downs, instrument losses, incision accuracy, and regularity.
• The Global Operative Assessment of Laparoscopic Skills (GOALS) checklist and Likert scale surveys were used.

Main Results:

• The simulator successfully differentiated between student and physician groups across all measured variables (p < 0.001).
• Physicians demonstrated significantly shorter procedure times, fewer look-downs, and instrument losses.
• Higher percentages of physicians respected incision limits and achieved regular incisions compared to students.
• Physicians outperformed students in all GOALS checklist domains.
• Over 96% of participants found the simulator enjoyable, realistic, and beneficial for training.

Conclusions:

• The endoscopic flavectomy simulator exhibits construct validity by differentiating experience levels.
• The simulator demonstrates high acceptability and perceived value among both novice and expert surgeons.
• This validated simulator is a promising tool for enhancing endoscopic spine surgery training.