title: Assessment of basic human performance resources predicts the performance of virtual ureterorenoscopy.
abstract: OBJECTIVE
  Regardless of training, innate ability may influence the acquisition of endoscopic skills. Until recently objective methods to assess innate ability have not been available. We compared objective measures of human basic performance resources (BPRs) using nonlinear causal resource analysis (NCRA) and expert rated endoscopic performance of medical students on a virtual reality (VR) simulator.
  
  
  METHODS
  BPRs were measured in 18 medical students (group 1) using 13 validated tests. BPR results were compared to the results of ureteroscopic skills assessment on the VR simulator. An NCRA model was devised to predict performance based on BPRs and the limiting performance resource (LPR). The same BPRs were measured in a second group of 14 medical students (group 2). Using the model created from group 1 performance of VR ureterorenoscopy was predicted based on LPR for each student in group 2. Predicted performance was compared to rated performance.
  
  
  RESULTS
  The average difference in score between 2 expert raters was 7.2%. The average difference in predicted score based on the NCRA model and rated score was only 8.0%. In 9 of the 14 group 2 subjects (63%) the performance prediction by NCRA was in excellent agreement (+/-10%) with the expert rating on the VR simulation. NCRA over predicted performance in 2 subjects (14%) and under predicted performance in 3 (21%).
  
  
  CONCLUSIONS
  Objective prediction of ureteroscopic performance in the VR environment using LPRs (measures of innate ability) for each subject is possible and practical using new measurement and modeling methods. The selection of surgical candidates, training and the educational curriculum could be impacted.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center, Dallas 75390, USA.
authors.forename: D Brooke
authors.initials: DB
authors.lastname: Johnson
authors.forename: George V
authors.initials: GV
authors.lastname: Kondraske
authors.forename: David M
authors.initials: DM
authors.lastname: Wilhelm
authors.forename: Lucas
authors.initials: L
authors.lastname: Jacomides
authors.forename: Kenneth
authors.initials: K
authors.lastname: Ogan
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Pearle
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D006801:Humans; D007668:Kidney; D008962:Models, Theoretical; D013647:Task Performance and Analysis; D018666:Ureteroscopy / Q000379:methods / Q000592:standards*