title: An "intermediate curriculum" for advanced laparoscopic skills training with virtual reality simulation.
abstract: OBJECTIVE
  To estimate face and construct validity for a novel curriculum designed for intermediately skilled laparoscopic surgeons on a virtual reality simulator. It consists of 5 exercises that focus on training precision and coordination between both hands.
  
  
  METHODS
  Prospective study (Canadian Task Force II-2).
  
  
  METHODS
  Three university hospitals and 4 teaching hospitals in the Netherlands.
  
  
  METHODS
  Residents, consultants, and laparoscopic experts (n = 69) in the fields of general surgery, gynecology, and urology participated. Participants were divided into 4 groups on the basis of their level of laparoscopic experience: resident, years 1-3 (n = 15); resident, years 4-6 (n = 17); consultant (n = 19); and laparoscopic experts (n = 18).
  
  
  METHODS
  Participants completed 3 runs of 5 exercises. The first run was an introduction, and the second and third runs were used for analysis. The parameters time, path length, collisions, and displacement were compared between groups. Afterward the participants completed a questionnaire to evaluate their laparoscopic experience and identify issues concerning the simulator and exercises.
  
  
  RESULTS
  The expert group was significantly faster (p <.05) than other groups in 4 of 5 exercises. The parameter displacement demonstrated a significant difference between the expert group and other groups in 2 of the 4 exercises in which this parameter was relevant (p <.05). In the questionnaire (n = 68), training capacity of the curriculum was scored with a median of 4 points on a 5-point Likert scale. Of all participants, 92.6% indicated that this curriculum is suitable as an addition to a basic skills module within their residency program.
  
  
  CONCLUSIONS
  Face and construct validity were estimated for an advanced virtual reality curriculum for intermediately skilled laparoscopic surgeons. The results indicate that the curriculum is suitable for training of residents and consultants and to assess and maintain their laparoscopic skills.
authors.affiliation: Department of Gynaecologic Surgery and Oncology, University Medical Centre, Utrecht, The Netherlands. h.w.r.schreuder@umcutrecht.nl
authors.forename: Henk W R
authors.initials: HW
authors.lastname: Schreuder
authors.forename: P Diederick
authors.initials: PD
authors.lastname: van Hove
authors.forename: Juliënne A
authors.initials: JA
authors.lastname: Janse
authors.forename: Rene R M
authors.initials: RR
authors.lastname: Verheijen
authors.forename: Laurents P S
authors.initials: LP
authors.lastname: Stassen
authors.forename: Jenny
authors.initials: J
authors.lastname: Dankelman
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000193:education* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D011446:Prospective Studies; D014584:User-Computer Interface