title: Assessing the learning curve for the acquisition of laparoscopic skills on a virtual reality simulator.
abstract: BACKGROUND
  The aim of this study was to develop summary metrics and assess the construct validity for a virtual reality laparoscopic simulator (LapSim) by comparing the learning curves of three groups with different levels of laparoscopic expertise.
  
  
  METHODS
  Three groups of subjects ('expert', 'junior', and 'naïve') underwent repeated trials on three LapSim tasks. Formulas were developed to calculate scores for efficiency ('time-error') and economy of 'motion' ('motion') using metrics generated by the software after each drill. Data (mean +/- SD) were evaluated by analysis of variance (ANOVA). Significance was set at p < 0.05.
  
  
  RESULTS
  All three groups improved significantly from baseline to final for both 'time-error' and 'motion' scores. There were significant differences between groups in time error performances at baseline and final, due to higher scores in the 'expert' group. A significant difference in 'motion' scores was seen only at baseline.
  
  
  CONCLUSIONS
  We have developed summary metrics for the LapSim that differentiate among levels of laparoscopic experience. This study also provides evidence of construct validity for the LapSim.
authors.affiliation: Department of Surgery, McGill University Health Centre, 1650 Cedar Avenue, L9.309 Montreal, Quebec H3G1A4, Canada.
authors.forename: V
authors.initials: V
authors.lastname: Sherman
authors.forename: L S
authors.initials: LS
authors.lastname: Feldman
authors.forename: D
authors.initials: D
authors.lastname: Stanbridge
authors.forename: R
authors.initials: R
authors.lastname: Kazmi
authors.forename: G M
authors.initials: GM
authors.lastname: Fried
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D004521:Educational Measurement; D004564:Electrocoagulation; D004724:Endoscopy / Q000193:education*; D013502:General Surgery / Q000193:education; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D007858:Learning; D019060:Minimally Invasive Surgical Procedures; D008953:Models, Anatomic; D010820:Physicians; D011597:Psychomotor Performance; D013337:Students, Medical; D013525:Surgical Instruments; D013996:Time and Motion Studies; D014584:User-Computer Interface