Construct validity for the LAPSIM laparoscopic surgical simulator.
BACKGROUND
The skills required for laparoscopic surgery are amenable to simulator-based training. Several computerized devices are now available. We hypothesized that the LAPSIM simulator can be shown to distinguish novice from experienced laparoscopic surgeons, thus establishing construct validity.


METHODS
We tested residents of all levels and attending laparoscopic surgeons. The subjects were tested on eight software modules. Pass/fail (P/F), time (T), maximum level achieved (MLA), tissue damage (TD), motion, and error scores were compared using the t-test and analysis of variance.


RESULTS
A total of 54 subjects were tested. The most significant difference was found when we compared the most (seven attending surgeons) and least experienced (10 interns) subjects. Grasping showed significance at P/F and MLA (p < 0.03). Clip applying was significant for P/F, MLA, motion, and errors (p < 0.02). Laparoscopic suturing was significant for P/F, MLA, T, TD, as was knot error (p < 0.05). This finding held for novice, intermediate, and expert subjects (p < 0.05) and for suturing time between attending surgeons and residents (postgraduate year [PGY] 1-4) (p < 0.05).


CONCLUSIONS
LAPSIM has construct validity to distinguish between expert and novice laparoscopists. Suture simulation can be used to discriminate between individuals at different levels of residency and expert surgeons.
Duffy
A J
AJ
Department of Surgery, Minimal Access Surgery Center, Weill Medical College of Cornell University, 525 East 68th Street, New York, NY 10021, USA.
Hogle
N J
NJ
McCarthy
H
H
Lew
J I
JI
Egan
A
A
Christos
P
P
Fowler
D L
DL
D002983:Clinical Competence; D003198:Computer Simulation; D007396:Internship and Residency; D010535:Laparoscopy