Virtual reality as a metric for the assessment of laparoscopic psychomotor skills. Learning curves and reliability measures.
BACKGROUND
The objective assessment of the psychomotor skills of surgeons is now a priority; however, this is a difficult task because of measurement difficulties associated with the assessment of surgery in vivo. In this study, virtual reality (VR) was used to overcome these problems.


METHODS
Twelve experienced (>50 minimal-access procedures), 12 inexperienced laparoscopic surgeons (<10 minimal-access procedures), and 12 laparoscopic novices participated in the study. Each subject completed 10 trials on the Minimally Invasive Surgical Trainer; Virtual Reality (MIST VR).


RESULTS
Experienced laparoscopic surgeons performed the tasks significantly (p < 0.01) faster, with less error, more economy in the movement of instruments and the use of diathermy, and with greater consistency in performance. The standardized coefficient alpha for performance measures ranged from a = 0.89 to 0.98, showing high internal measurement consistency. Test-retest reliability ranged from r = 0.96 to r = 0.5.


CONCLUSIONS
VR is a useful tool for evaluating the psychomotor skills needed to perform laparoscopic surgery.
Gallagher
A G
AG
Northern Ireland Center for Endoscopic Training and Research, Queen's University of Belfast, Belfast, Ireland.
Satava
R M
RM
D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data; D004864:Equipment and Supplies; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D007858:Learning; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000193:education* / Q000706:statistics & numerical data; D011597:Psychomotor Performance; D012015:Reference Standards; D018709:Statistics, Nonparametric; D014584:User-Computer Interface