title: The Tube 3 module designed for practicing vesicourethral anastomosis in a virtual reality robotic simulator: determination of face, content, and construct validity.
abstract: OBJECTIVE
  To better use virtual reality robotic simulators and offer surgeons more practical exercises, we developed the Tube 3 module for practicing vesicourethral anastomosis (VUA), one of the most complex steps in the robot-assisted radical prostatectomy procedure. Herein, we describe the principle of the Tube 3 module and evaluate its face, content, and construct validity.
  
  
  METHODS
  Residents and attending surgeons participated in a prospective study approved by the institutional review board. We divided subjects into 2 groups, those with experience and novices. Each subject performed a simulated VUA using the Tube 3 module. A built-in scoring algorithm recorded the data from each performance. After completing the Tube 3 module exercise, each subject answered a questionnaire to provide data to be used for face and content validation.
  
  
  RESULTS
  The novice group consisted of 10 residents. The experienced subjects (n = 10) had each previously performed at least 10 robotic surgeries. The experienced group outperformed the novice group in most variables, including task time, total score, total economy of motion, and number of instrument collisions (P <.05). Additionally, 80% of the experienced surgeons agreed that the module reflects the technical skills required to perform VUA and would be a useful training tool.
  
  
  CONCLUSIONS
  We describe the Tube 3 module for practicing VUA, which showed excellent face, content, and construct validity. The task needs to be refined in the future to reflect VUA under real operating conditions, and concurrent and predictive validity studies are currently underway.
authors: Department of Urology, Korea University School of Medicine, Seoul, Republic of Korea.
authors: Sung Gu
authors: SG
authors: Kang
authors: Department of Urology, Korea University School of Medicine, Seoul, Republic of Korea.
authors: Seok
authors: S
authors: Cho
authors: Department of Urology, Korea University School of Medicine, Seoul, Republic of Korea.
authors: Seok Ho
authors: SH
authors: Kang
authors: Department of Urology, the Global Robotics Institute, Florida Hospital Celebration Health, and University of Central Florida School of Medicine, Celebration, Florida.
authors: Abdul Muhsin
authors: AM
authors: Haidar
authors: Department of Urology, the Global Robotics Institute, Florida Hospital Celebration Health, and University of Central Florida School of Medicine, Celebration, Florida.
authors: Srinivas
authors: S
authors: Samavedi
authors: Department of Urology, the Global Robotics Institute, Florida Hospital Celebration Health, and University of Central Florida School of Medicine, Celebration, Florida.
authors: Kenneth J
authors: KJ
authors: Palmer
authors: Department of Urology, the Global Robotics Institute, Florida Hospital Celebration Health, and University of Central Florida School of Medicine, Celebration, Florida.
authors: Vipul R
authors: VR
authors: Patel
authors: Department of Urology, Korea University School of Medicine, Seoul, Republic of Korea. Electronic address: jcheon@korea.ac.kr.
authors: Jun
authors: J
authors: Cheon
mesh_terms: D000714:Anastomosis, Surgical / Q000193:education*; D003198:Computer Simulation; D006801:Humans; D011446:Prospective Studies; D015203:Reproducibility of Results; D012371:Robotics / Q000193:education*; D011795:Surveys and Questionnaires; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000193:education*