title: Enabling, implementing, and validating training methods in laparoscopic surgery.
abstract: BACKGROUND
  The challenges of teaching and learning technical skills for laparoscopic surgery have limited the use of laparoscopy for complex abdominal surgery. In an attempt to facilitate learning these skills, surgical educators are using simulators, but there is little conclusive evidence that simulators can predict improved performance by surgical trainees receiving training on them (predictive validity).
  
  
  METHODS
  In the present study the results of three attempts to establish predictive validity for a virtual laparoscopic simulator were reviewed. In each study, the performance of surgery residents before and after training on the simulator was documented by means of a validated assessment tool, and then the results were compared.
  
  
  RESULTS
  Some task performance was improved by training on the simulator, but predictive validity could not be established for the simulator in any of the three attempts to do so.
  
  
  CONCLUSIONS
  Although predictive validity for the virtual simulator was not conclusively established, reasons for this failure are discussed. Based on the evidence that training on simulators results in some task performance improvement, future studies are justified to better define more effective use of the simulator.
authors.affiliation: Columbia University College of Physicians & Surgeons, New York, NY, USA. dlf91@caa.columbia.edu
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Fowler
mesh_terms: D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D004724:Endoscopy / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D011446:Prospective Studies; D013647:Task Performance and Analysis; D014584:User-Computer Interface