title: A multicenter prospective cohort study on camera navigation training for key user groups in minimally invasive surgery.
abstract: BACKGROUND
  Untrained laparoscopic camera assistants in minimally invasive surgery (MIS) may cause suboptimal view of the operating field, thereby increasing risk for errors. Camera navigation is often performed by the least experienced member of the operating team, such as inexperienced surgical residents, operating room nurses, and medical students. The operating room nurses and medical students are currently not included as key user groups in structured laparoscopic training programs. A new virtual reality laparoscopic camera navigation (LCN) module was specifically developed for these key user groups.
  
  
  METHODS
  This multicenter prospective cohort study assesses face validity and construct validity of the LCN module on the Simendo virtual reality simulator. Face validity was assessed through a questionnaire on resemblance to reality and perceived usability of the instrument among experts and trainees. Construct validity was assessed by comparing scores of groups with different levels of experience on outcome parameters of speed and movement proficiency.
  
  
  RESULTS
  The results obtained show uniform and positive evaluation of the LCN module among expert users and trainees, signifying face validity. Experts and intermediate experience groups performed significantly better in task time and camera stability during three repetitions, compared to the less experienced user groups (P < .007). Comparison of learning curves showed significant improvement of proficiency in time and camera stability for all groups during three repetitions (P < .007).
  
  
  CONCLUSIONS
  The results of this study show face validity and construct validity of the LCN module. The module is suitable for use in training curricula for operating room nurses and novice surgical trainees, aimed at improving team performance in minimally invasive surgery.
authors.affiliation: Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Maurits
authors.initials: M
authors.lastname: Graafland
authors.affiliation: Division of Woman & Baby, Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Kiki
authors.initials: K
authors.lastname: Bok
authors.affiliation: Division of Woman & Baby, Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Henk W R
authors.initials: HW
authors.lastname: Schreuder
authors.affiliation: Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands m.p.schijven@amc.uva.nl.
authors.forename: Marlies P
authors.initials: MP
authors.lastname: Schijven
mesh_terms: D000328:Adult; D015331:Cohort Studies; D006804:Ergonomics; D005260:Female; D006801:Humans; D059032:Learning Curve; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D009726:Nurses; D011446:Prospective Studies; D013337:Students, Medical; D025321:Surgery, Computer-Assisted / Q000193:education*
keywords: ergonomics; evidence-based medicine/surgery; human factors study; simulation; surgical education