title: Development and validation of a pediatric laparoscopic surgery simulator.
abstract: BACKGROUND
  Although a validated simulator exists for adult laparoscopy, there is no pediatric counterpart. The objective of this study is to develop and validate a pediatric laparoscopic surgery (PLS) simulator.
  
  
  METHODS
  A PLS simulator was developed. Participants were stratified according to level of expertise and tested on the fundamentals of laparoscopic surgery (FLS) and PLS simulators. A subsequent group was tested exclusively on the PLS simulator.
  
  
  RESULTS
  The PLS intracorporeal suturing score was lower than its adult counterpart (P = .02). The PLS pattern-cutting score was higher than in the FLS simulator (P < .001). If the latter was eliminated from the calculation, the revised total FLS score was significantly better than the revised PLS score. When all participants were combined, total PLS scores as well as performance on 3 of 5 tasks allowed differentiation between novice, intermediate, and expert.
  
  
  CONCLUSIONS
  The PLS simulator was able to discriminate between the novice, intermediate, and expert using the total PLS score and the performance on 3 of the 5 tasks, thus providing evidence for construct validity. The other 2 tasks will require formal modification or a change in the scoring metrics to establish their independent construct validity.
authors: Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8. georges.azzie@sickkids.ca
authors: Georges
authors: G
authors: Azzie
authors: J Ted
authors: JT
authors: Gerstle
authors: Ahmed
authors: A
authors: Nasr
authors: David
authors: D
authors: Lasko
authors: Jessica
authors: J
authors: Green
authors: Oscar
authors: O
authors: Henao
authors: Monica
authors: M
authors: Farcas
authors: Allan
authors: A
authors: Okrainec