Designing a proficiency-based, content validated virtual reality curriculum for laparoscopic colorectal surgery: a Delphi approach.
BACKGROUND
Although task training on virtual reality (VR) simulators has been shown to transfer to the operating room, to date no VR curricula have been described for advanced laparoscopic procedures. The purpose of this study was to develop a proficiency-based VR technical skills curriculum for laparoscopic colorectal surgery.


METHODS
The Delphi method was used to determine expert consensus on which VR tasks (on the LapSim simulator) are relevant to teaching laparoscopic colorectal surgery. To accomplish this task, 19 international experts rated all the LapSim tasks on a Likert scale (1-5) with respect to the degree to which they thought that a particular task should be included in a final technical skills curriculum. Results of the survey were sent back to participants until consensus (Cronbach's α >0.8) was reached. A cross-sectional design was utilized to define the benchmark scores for the identified tasks. Nine expert surgeons completed all identified tasks on the "easy," "medium," and "hard" settings of the simulator.


RESULTS
In the first round of the survey, Cronbach's α was 0.715; after the second round, consensus was reached at 0.865. Consensus was reached for 7 basic tasks and 1 advanced suturing task. Median expert time and economy of movement scores were defined as benchmarks for all curricular tasks.


CONCLUSIONS
This study used Delphi consensus methodology to create a curriculum for an advanced laparoscopic procedure that is reflective of current clinical practice on an international level and conforms to current educational standards of proficiency-based training.
University of Toronto, Toronto, Ontario, Canada. Vanessa.palter@utoronto.ca
Vanessa N
VN
Palter
Maurits
M
Graafland
Marlies P
MP
Schijven
Teodor P
TP
Grantcharov
D003107:Colorectal Surgery / Q000193:education*; D003194:Computer-Assisted Instruction / Q000379:methods*; D003479:Curriculum; D003697:Delphi Technique; D005104:Expert Testimony; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D014584:User-Computer Interface