Expanding Global Laparoscopic Training: Validity Testing of a Ugandan-Manufactured Box Trainer

Area of Science:

• Surgical Education
• Medical Devices
• Global Health

Background:

• Laparoscopic surgical training is essential, particularly in resource-limited settings like Africa.
• The KeyTrainer (KT) is a novel, affordable laparoscopic box trainer manufactured in Uganda, featuring tasks tailored to the African context.
• This study aimed to validate the KT for its effectiveness in surgical training.

Purpose of the Study:

• To assess the construct validity of the KeyTrainer (KT) by evaluating its ability to differentiate skill levels among surgical trainees and faculty.
• To evaluate the content validity of the KT through user feedback on task relevance and skill development.
• To determine the feasibility of the KT as a training tool in sub-Saharan Africa.

Main Methods:

• Validity testing involved 41 participants (26 Ugandan, 18 US) including medical students, residents, and laparoscopic faculty.
• Participants completed 5 laparoscopic tasks adapted from the Fundamentals of Laparoscopic Surgery (FLS) curriculum.
• Construct validity was analyzed by comparing task completion times and error rates across different training levels; content validity was assessed via post-experience surveys.

Main Results:

• Task performance times significantly differed across student, resident, and faculty groups (p < 0.05), confirming construct validity.
• While US participants were faster on the FLS trainer, both the FLS and KT systems effectively identified skill level differences.
• Over 90% of participants found the KT tasks improved essential surgical skills, and 89% endorsed its future use, supporting content validity.

Conclusions:

• The KeyTrainer (KT) demonstrated both construct and content validity, proving its capability to distinguish between varying skill levels in laparoscopic surgery.
• The KT offers a practical, locally-sourced solution for enhancing laparoscopic surgical training in sub-Saharan Africa.
• The validated trainer has the potential to improve surgical education and patient outcomes in the region.