title: Development of a novel iPad-based laparoscopic trainer and comparison with a standard laparoscopic trainer for basic laparoscopic skills testing.
abstract: BACKGROUND
  We developed the iTrainer (iT) as a portable laparoscopic trainer, which incorporates the iPad tablet. We then compared the iT with a standard pelvic trainer (SPT) to assess surgical skills as well as its image quality, resolution, brightness, comfort, and overall performance.
  
  
  METHODS
  We designed and constructed the iT to be compatible with the Apple iPad 3 and standard laparoscopic instruments. Participants were assigned to perform the thread-the-loops task on both trainers and were prospectively randomized to start on either the iT or the SPT. Each participant was allowed a 2-minute warm-up before the 2-minute testing period. We scored participants using the product of skill quality (0-4 scale) and quantity of loops threaded (0-10 scale). Participants then rated each trainer on image quality, resolution, brightness, comfort, and overall performance on a 5-point Likert scale.
  
  
  RESULTS
  A total of 45 subjects including 10 undergraduates, 10 medical students, 10 general surgery and urology residents, and 15 experts (fellows and attending surgeons) participated in this study. There was no significant difference between thread-the-loops task scores completed on the iT when compared with the SPT for all groups tested (p > 0.05) with the exception of the medical student group, who performed better on the SPT (p < 0.05). On evaluation of each trainer, participants rated the iT as having superior image quality and resolution when compared with the SPT (p < 0.05) but rated the SPT higher in overall performance (p < 0.05). Brightness and comfort were rated similarly for both trainers.
  
  
  CONCLUSIONS
  We have demonstrated face validity and criterion validity for the thread-the-loops task on the iT. The iT rated superior in image quality and resolution but inferior in overall performance compared with the SPT. The iT provides trainees a unique advantage over SPT as an additional resource to laparoscopic training as it is inexpensive, portable, and can be readily available for training.
authors: Department of Urology, University of California, Irvine, California.
authors: Renai
authors: R
authors: Yoon
authors: Department of Urology, University of California, Irvine, California.
authors: Michael
authors: M
authors: Del Junco
authors: Department of Urology, University of California, Irvine, California.
authors: Adam
authors: A
authors: Kaplan
authors: Department of Urology, University of California, Irvine, California.
authors: Zhamshid
authors: Z
authors: Okhunov
authors: Department of Urology, University of California, Irvine, California.
authors: Philip
authors: P
authors: Bucur
authors: Department of Urology, University of California, Irvine, California.
authors: Martin
authors: M
authors: Hofmann
authors: Department of Urology, University of California, Irvine, California.
authors: Reza
authors: R
authors: Alipanah
authors: Department of Urologic Sciences, University of British Columbia, Vancouver, Canada.
authors: Elspeth M
authors: EM
authors: McDougall
authors: Department of Urology, University of California, Irvine, California. Electronic address: landmanj@uci.edu.
authors: Jaime
authors: J
authors: Landman
mesh_terms: D002983:Clinical Competence; D034201:Computers, Handheld; D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D013536:Suture Techniques
keywords: Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; iPad; laparoscopy; skills; trainer