title: Face, content and construct validity of a new realistic trainer for conventional techniques in digestive surgery.
abstract: OBJECTIVE
  Surgical simulation modules for "open" surgery are limited in contrast to well-studied and validated laparoscopic trainers. In this study, face, content and construct validity of a devised simulation module (Berlin Operation Trainer, BOPT) for handsewn anastomoses in digestive surgery were analysed.
  
  
  METHODS
  Participants of a skills course for digestive surgery (novices: 1-3 years of training; experts: more than 5 years of training) were timed on performing four defined handsewn digestive anastomoses on formalin fixed porcine intestine in the BOPT. Questionnaires were answered regarding impression with the simulation module concerning appearance and realism using a five-point Likert and a three-point forced choice scale. Face and content validities were evaluated based on the responses of participants and construct validity by comparing novices to experts. Data collected were analysed with Fisher's exact test and two-sample t test.
  
  
  RESULTS
  Twenty-two novices (median: second postgraduate year) and 26 experts (median: seventh postgraduate year) were enrolled in the study. The BOPT showed strong face and content validities with average scores for satisfaction parameters above 4.2 +/- 0.41 and 4.1 +/- 0.22, respectively. Construct validity was adequate for anastomosis simulation in the BOPT based on different percentages of anastomosis complete during set time between novices and experts as shown for simple (68.2% vs. 92.3%, p = 0.038) and for difficult anastomosis (18.2% vs. 50.0%, p = 0.021).
  
  
  CONCLUSIONS
  The BOPT is a suitable instrument for advanced surgical training for novices and experienced colleagues creating a realistic and demanding situation. Further studies have to evaluate if a more realistic preoperative training will support an effective transfer of learned techniques to the operating room.
authors.affiliation: Department of General, Vascular and Thoracic Surgery, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany. joern.groene@charite.de
authors.forename: Jörn
authors.initials: J
authors.lastname: Gröne
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Lauscher
authors.forename: Heinz J
authors.initials: HJ
authors.lastname: Buhr
authors.forename: Joerg-Peter
authors.initials: JP
authors.lastname: Ritz
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000193:education / Q000592:standards; D000818:Animals; D002983:Clinical Competence; D003198:Computer Simulation; D013505:Digestive System Surgical Procedures / Q000193:education* / Q000592:standards*; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017792:Surgical Stapling / Q000193:education / Q000592:standards; D011795:Surveys and Questionnaires; D013536:Suture Techniques / Q000193:education / Q000592:standards; D013552:Swine; D014584:User-Computer Interface